A Study on the Mental Health and Burnout of Medical Staff Responding to the Coronavirus Disease 2019 / 신경정신의학

Objectives@#This study was conducted to identify the level of mental health and burnout of medical staff at hospitals and public health centers, which responded to the coronavirus disease 2019 (COVID-19) in South Korea and to suggest appropriate management plans. @*Methods@#The mental health and burnout levels of medical staff responding to COVID-19 were evaluated through an online survey conducted during the period July 1–14, 2021. To analyze the mental health status of the participants according to their demographic characteristics, the chisquare test, t-test, and an analysis of variance were conducted, followed by Scheffe post-hoc tests for pairwise comparisons. @*Results@#A total of 773 participants were included in the study. An analysis of the clinically significant symptoms of the group showed that 29.5% had posttraumatic stress symptoms, 30.6% had depression, 15.8% had anxiety, 39.8% had somatic symptoms, and 4.5% were seen to be at risk of suicide. The average scores for burnout were as follows: 3.55±1.75 for emotional exhaustion, 2.68±1.73 for depersonalization, and 3.89±1.40 for personal accomplishment. Mental health problems and burnout were found to be high in women, those in the 20–39-year age bracket, those with less than 5 years of work experience, and public health center workers. @*Conclusion@#The medical staff responding to COVID-19 were observed to experience high levels of mental health and burnout problems. Work-related characteristics, such as younger age, lower work experience, and employment at a public health center, may have a negative impact on mental health and cause burnout. Therefore, individualized and systemic support for mental health and to prevent the burnout of medical staff responding to cases of COVID-19 is needed.

Psychosocial Review of Vaccine Hesitancy / 신경정신의학

Achieving herd immunity against COVID-19 through vaccination is considered an important strategy for controlling the epidemic. However, as is the case for other infectious diseases, many people are hesitant to vaccinate. Underestimating the risk of disease, inconvenience of the inoculation process, concerns about effectiveness and safety, autonomy and personal belief, lack of altruism, and antipathy are psychosocial factors that lead to vaccine hesitancy. It is important to acknowledge and understand these concerns and fears rather than criticize individuals. To achieve herd immunity, the government must provide accurate information and improve accessibility through various windows to encourage individuals to make reasoned decisions.

Psychological Effects of the Coronavirus Disease 2019 Pandemic / 대한내과학회지

The novel coronavirus disease 2019 (COVID-19) pandemic has spread across the world, reducing social interactions and causing substantial psychological distress and economic losses. This review summarizes the psychological effects of the COVID-19 pandemic in terms of uncertainty, the loss of autonomy associated with preventive measures, and secondary stressors such as potential future economic losses.

Psychological Effects of the Coronavirus Disease 2019 Pandemic / 대한내과학회지

The novel coronavirus disease 2019 (COVID-19) pandemic has spread across the world, reducing social interactions and causing substantial psychological distress and economic losses. This review summarizes the psychological effects of the COVID-19 pandemic in terms of uncertainty, the loss of autonomy associated with preventive measures, and secondary stressors such as potential future economic losses.

Psychological Responses among Humidifier Disinfectant Disaster Victims and Their Families

To substantiate psychological symptoms following humidifier disinfectant (HD) disasters, counseling records of 26 victims and 92 family members of victims (45 were bereaved) were analyzed retrospectively. Among the victims, 34.6% had Clinical Global Impression-Severity scores of over 4, which meant they were moderately ill. While anxiety/fear and depression with respiratory symptoms were frequently observed in victims and family members, chronic psychological distress such as alcohol/smoking abuse and insomnia was relatively high in bereaved family members. In conclusion, it is important to provide mental health support for victims and their families, focusing on the characteristic symptoms of each group as well as monetary compensation.

Development of Korean Disaster Mental Health Support Guidelines: Results of a Scoping Review and a Delphi Survey

OBJECTIVE@#It is necessary to develop new guidelines to delineate the best ways of providing psychosocial care to ensure mental health following a disaster.@*METHODS@#This study applied the scoping review method as a means of establishing evidence-based guidelines for disaster mental health services. A total of 440 literatures were selected through a scoping review of 20,864 documents. Twenty-three recognized experts were invited to participate in the survey and a two-round online Delphi survey was conducted.@*RESULTS@#The concordance rate in the Delphi Round 1 was 95.1%. Six items were excluded and new items were formulated with experts’ suggestions. A total of 23 statements were slightly modified to clarify their meaning. In the Delphi Round 2, all items were met with consensus. The three items with the highest consensus among the experts were related to the protection of personal information and privacy. The item with the lowest consensus among experts was related to debriefing. Other items were related to establishing mental health support centers and suicide prevention activities.@*CONCLUSION@#140 items were developed through scoping reviews based on evidence-based methodology. These items were used to describe the disaster mental health support identified in Delphi. The guideline will provide a foundation for effective preparation and response in disaster situations.

Investigating the Intrapsychic Factors that Affect Quality of Life in Patients with Schizophrenia / 대한정신분열병학회지

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.

Psychological trauma of Middle East Respiratory Syndrome victims and bereaved families / 한국역학회지

No abstract available.

Relationship between Traumatic Events, Stress Coping Strategies and Post-Traumatic Stress Symptoms among Social Workers in Public Sector

OBJECTIVES: Social workers can suffer from occupational stress resulting from dealing with clients, which might lead to metal health problems. We aimed to investigate the association of duty-related traumatic experiences and stress coping strategies with posttraumatic stress symptoms among social workers in public sector. METHODS: A total of 110 social workers in public sector (men 30.9%, 36.5 +/- 7.6 yrs) participated in this study. All subjects were evaluated the frequency and the impact of duty-related traumatic events. Additionally, they completed questionnaires including the Impact of Event Scale-Revised for post-traumatic stress symptoms, the Beck Depression Inventory-II for depressive symptoms, the Scale for Suicidal Ideation for suicide symptoms and the Ways of Coping Checklist for stress coping strategies. RESULTS: The most frequent traumatic events were "Violent or abusive language from a client" (95.0%) and "Client made a fuss" (94.5%). The most distressing traumatic event was "Seeing a dead body on duty" (7.6 out of 10), which predicted post-traumatic stress symptoms (odds ratio 4.04 ; 95% confidence interval, 1.79-9.11). Among 4 types of stress coping strategies, the emotion-focused coping was positively correlated with post-traumatic stress symptoms after controlling age and sex (beta = 0.50, p < 0.001). CONCLUSIONS: Social workers in public sector showed high level of post-traumatic stress symptoms. Duty-related traumatic events and the emotional-focused coping strategies were associated with the severity of post-traumatic stress symptoms. The modification of stress coping strategies would alleviate post-traumatic stress symptoms in social workers in public sector.

Multivariate Analysis of Relationship between Childhood Trauma and Psychotic Symptoms in Patients with Schizophrenia

The aim of this study was to examine the relationship between childhood trauma and psychotic symptoms in schizophrenic patients after controlling for the possible confounding factors, such as depression and dissociative symptoms. Ninety-eight schizophrenic inpatients participated. Childhood trauma was examined using the Childhood Trauma Questionnaires (CTQ), which consists of physical abuse (PA), sexual abuse (SA), emotional abuse (EA), physical neglect (PN), and emotional neglect (EN). Positive and Negative Syndrome Scale (PANSS), Dissociative Experience Scale (DES), and Beck's Depression Inventory (BDI) were also administered. Data were analyzed by partial correlation and general linear model. The total score of CTQ was positively correlated with positive, general, and total scores of PANSS. All five types of childhood trauma were associated with dissociative symptoms. EA and EN were positively correlated with depressive symptoms. Only SA significantly predicted positive symptoms of schizophrenia after controlling for age, sex, BDI, and DES scores, with a dose-response relationship between SA and positive symptoms.

Psychological Reactions and Physical Trauma by Types of Disasters: View from Man-Made Disaster / 신경정신의학

A variety of psychological and physical symptoms may appear in disaster victims. The type of disaster as well as individual factors could affect the pattern and severity of symptoms. Several reports have shown that fire survivors suffered from survivor guilt, re-experience, and fear of fire and burn scars associated with depressive symptoms. Inhalation burns are of special interest because of the possibility of delayed systemic complications. Large traffic accident causes more frequent and severe post-traumatic stress symptoms (PTSS), particularly intrusive thoughts, compared to general road traffic accident. Traumatic brain injury and serious physical injuries could increase the PTSS expression. Considering that tragic collapse accidents occurred mainly as a result of careless construction, anger and mistrust are understandable. Legal disputes and compensation issues can provoke social conflict and prolonged suffering. Understanding the psychological characteristics and responses will be required in order to support the mental health of disaster victims.

Mental Health of Disaster Workers / 신경정신의학

We sought to gain insights on the prevalence of psychiatric disorders, the risk and protective factors and the prevention and intervention programs of mental health problems among disaster workers. The prevalence of Posttraumatic Stress Disorder (PTSD) among disaster workers was higher than that of the general population and lower than that of disaster survivors. They might suffer from various mental health problems and comorbid disorders. Those mental problems could affect not only their physical health but also self-medication, life satisfaction, and job functioning. Heterogeneous and various factors were positively and negatively associated with psychiatric problems. Prevention and intervention programs were summarized for PTSD among disaster workers. Self-help technique 'RESCUE' and cognitive behavior therapy, developed especially for disaster workers was introduced. Future research and directions were suggested.

Stress Coping Strategies and Quality of Life in Patients with Schizophrenia / 신경정신의학

OBJECTIVES: The aims of this study were to investigate the pattern of stress coping strategies and the effects of stress coping strategies on quality of life in patients with schizophrenia. METHODS: Stress coping strategies and quality of life were examined using Ways of Coping Checklist and Schizophrenia Quality of Life Scale for 98 patients with schizophrenia. Stress coping strategies were composed of problem-focused coping, social support seeking, emotion-focused coping, and wishful thinking. Among these, problem-focused coping and social support seeking were active coping strategies while emotion-focused coping and wishful thinking were passive coping strategies. Positive and Negative Syndrome Scale (PANSS) and Beck's Depression Inventory (BDI) were also administered. RESULTS: Active coping scores were higher than passive coping scores in patients with schizophrenia. Quality of life was higher in the active coping group compared to the passive coping group. Active coping usage was a significant predictor of higher quality of life even after controlling for gender, age, PANSS, and BDI scores. CONCLUSION: Patients with schizophrenia used more active coping strategies than passive coping strategies, which showed significant association with higher quality of life. A treatment program to provide education on use of active coping strategies in a proper and flexible way might contribute to enhanced quality of life in patients with schizophrenia.

The Sewol Ferry Accident and Early Mental Health Care Response by Volunteer Activities of Korean Disaster Mental Health Committee and Members of Korean Neuropsychiatric Association / 신경정신의학

On 16 April 2014, the Sewol ferry, carrying 476 people, sank in the ocean off the south coast of South Korea. Two hundred and ninety five are confirmed dead and 9 remain missing. The Korean Neuropsychiatric Association (KNPA) set up a Disaster Mental Health Committee (KDMHC) for out-reach services and to provide general strategies for promoting mental health and resilience. Mem bers of KDMHC and Volunteering Psychiatrists of the KNPA had participated in disaster mental health services organized by Gyeonggi-Ansan disaster mental health support team. Their activities were composed of psychoeducation, supportive individual and familial counseling and referring service to professional institutes. This report has described the outline of the initial and acute mental health care responses by KDMHC and volunteers among KNPA members.

Changes of Clinical Benefit and Subjective Wellbeing after Switching to Extended Release Quetiapine Furmate (Quetiapine XR) in Patients with Schizophrenia: Naturalistic, Observational Study (CLIMAX Study) / 대한정신약물학회지

OBJECTIVE: The aim of this study was to demonstrate changes of clinical benefit and subjective wellbeing after once-daily extended release quetiapine furmate (quetiapine XR) in patients with schizophrenia. METHODS: In a naturalistic, observational, and multicentric study, 1,494 patients with schizophrenia who switched to quetiapine XR (flexible dosing) due to insufficient efficacy or intolerance were recruited. Clinical Global Impressions-Clinical Benefit (CGI-CB), CGI-Severity (CGI-S), CGI-Improvement (CGI-I) and Subjective Wellbeing under Neuroleptic Treatment Scale (SWN-K) were assessed at baseline and after 8 weeks treatment. We also examined factors related to changes of CGI-CB and SWN-K scores using linear regression analysis. RESULTS: Among 1,494 patients, 1,342 patients (89.8%) completed this study and 1,204 patients (80.6%) without protocol violation were included in the analysis. The mean dose of quetiapine XR was 416.9+/-205.8 mg/day at the initiation and continuously increased to 591.6+/-228.3 mg/day until week 5. At the endpoint, the mean dose of quetiapine XR was 580.24+/-382.24 mg/day. Both CGI-CB and CGI-S scores were significantly decreased after 8 weeks (both p<0.0001) and 745 patients (61.9%) achieved clinical benefit. Mean CGI-I scores were 2.49+/-0.80 and the response rate defined as CGI-I< or =2 was 51.6%. Subjective wellbeing scores were increased after 8 weeks (p<0.0001). Improvements of CGI-CB and subjective wellbeing were associated with quetiapine XR dosages as well as age and baseline scores. CONCLUSION: After switching to quetiapine XR, 61.9% of patients with schizophrenia who had a history of unsatisfactory treatment (efficacy or tolerance) showed clinical benefit and subjective wellbeing was significantly increased. Regarding that dosages of quetiapine XR were associated with improvements of clinical benefit and subjective wellbeing, active treatment strategies with higher dosages of quetiapine XR could be suggested in the real field.

Depressive Symptoms and Associated Factors in Caregivers of Patients with Chronic Mental Illness / 신경정신의학

OBJECTIVES: It has been reported that caregivers of patients with chronic mental illness including schizophrenia are in higher risk for psychological and physical health problem. This study was performed to evaluate the depressive symptoms and associated factors in caregivers of patients with chronic mental illness. METHODS: The subjects were 77 unaffected caregivers (30 parents, 30 siblings, 10 offspring, and 7 spouses) of patients with chronic mental illness (62 schizophrenia, 4 schizoaffective disorder, 11 bipolar disorder) and 100 healthy controls. Depressed mood was assessed by Beck Depression Inventory (BDI) in all subjects. For their sick family members, clinical factors including psychotic symptoms using the Positive and Negative Syndrome Scale (PANSS), duration of illness, number of admission were assessed. RESULTS: The mean BDI score of the caregivers was significantly higher than that of control subjects (11.2+/-11.6 and 8.0+/-7.5). Given that 23.4% of family group and 23.0% of control group are attributed to mild to moderate depressed state and 22.0% of family group and 8.0% of control group to above moderate depressed state, significant depressive symptom is more frequently observed in family group. The mean BDI score of parent group was higher than that of sibling group controlling for sex and age. In the parent group, BDI scores are positively correlated with age while the offspring and spouse group had negative correlation between BDI scores and age. Higher age, lower socioeconomic state, more severe positive symptom scores of patients were potential predictors for BDI scores of caregivers. CONCLUSION: This study showed that caregivers of patients with chronic mental illness have significant depressive symptoms. It may be suggested that depressive symptoms of caregivers are associated with aging, low socioeconomic state, and severe positive symptom rather than chronicity of their sick family members.