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Objective@#We investigated the differences in suicidality between young people and older adults with depression over the course of 12-week naturalistic treatment with antidepressants. @*Methods@#A total of 565 patients who had moderate to severe depression (Hamilton Depression Rating Scale [HAM-D] score ≥14) and significant suicidal ideation (Beck Scale for Suicide Ideation [SSI-B] score ≥6) were recruited from 18 hospitals. Participants were classified into two groups: the younger group (13–24 years of age, n=82) and the older group (≥25 years of age, n=483). Total scores over time on the SSI-B, HAM-D, and Hamilton Anxiety Rating Scale (HAM-A) were assessed and compared between the two groups. @*Results@#At baseline, the younger group had lower HAM-D scores (21.0 vs. 22.2; p=0.028) but higher SSI-B scores (19.4 vs. 15.6; p<0.001) compared with the older group. The overall 12-week proportion of patients with resolved suicidality was 44.1% in the younger group and 69.2% in the older group. Although the improvement in the HAM-D and HAM-A scores did not differ between the groups, suicidal ideation in the younger group remained more severe than in the older group throughout the treatment. The ratio of the subjects who achieved HAM-D remission or response but did not achieve SSI-B remission was significantly higher in the younger group than in the older group. @*Conclusion@#These data suggest that in depressed youths, suicide risk is a serious concern throughout the course of depression even when favorable treatment outcomes are obtained.
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This study aims to explore the impact of distributional changes in coronavirus disease 2019 (COVID-19) infection fear with sex differences. A quota sampling strategy was followed and 483 Korean adults were surveyed in a community sample. Self-report questionnaires were used to assess COVID-19 infection fear, depressive symptoms, and general characteristics.Quantile regression was used to explore the regression relationship of COVID-19 infection fear and an individual’s sex. There was a significant difference in COVID-19 infection fear (P= 0.001) and depression (P = 0.008) between the sexes - male and female. The differences between sexes at the 20th and 30th percentiles were significant (β = 2.04, P = 0.006; β = 1.5, P = 0.004, respectively). The results demonstrate that sex significantly predicts COVID-19 infection fear and women had significantly greater fear than men in the mild-level of COVID-19 infection fear.
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Objective@#The Functioning Assessment Short Test (FAST) is a relatively specific test for bipolar disorders designed to assess the main functioning problems experienced by patients. This brief instrument includes 24 items assessing impairment or disability in 6 domains of functioning: autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships, and leisure time. It has already been translated into standardized versions in several languages. The aim of this study is to measure the validity and reliability of the Korean version of FAST (K-FAST). @*Methods@#A total of 209 bipolar disorder patients were recruited from 14 centers in Korea. K-FAST, Young Mania Rating Scale (YMRS), Bipolar Depression Rating Scale (BDRS), Global Assessment of Functioning (GAF) and the World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were administered, and psychometric analysis of the K-FAST was conducted. @*Results@#The internal consistency (Cronbach’s alpha) of the K-FAST was 0.95. Test-retest reliability analysis showed a strong correlation between the two measures assessed at a 1-week interval (ICC = 0.97; p ＜ 0.001). The K-FAST exhibited significant correlations with GAF (r = −0.771), WHOQOL-BREF (r = −0.326), YMRS (r = 0.509) and BDRS (r = 0.598). A strong negative correlation with GAF pointed to a reasonable degree of concurrent validity. Although the exploratory factor analysis showed four factors, the confirmatory factor analysis of questionnaires had a good fit for a six factors model (CFI = 0.925; TLI = 0.912; RMSEA = 0.078). @*Conclusion@#The K-FAST has good psychometric properties, good internal consistency, and can be applicable and acceptable to the Korean context.
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This study examined factors related to high fear of coronavirus disease 2019 (COVID-19) infection in healthcare workers (HCWs) in COVID-19 dedicated teams. We assigned 371 HCWs to low, medium, and high COVID-19 infection fear groups, and investigated factors associated with COVID-19 infection fear. High COVID-19 infection fear was significantly associated with being a woman and poor professional quality of life. High COVID-19 infection fear group had higher burnout levels and secondary traumatic stress scores than the low and medium fear groups. These findings deepen our understanding of risk factors for and psychological outcomes of COVID-19 infection fear in HCWs.
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Background@#This study was conducted to examine the effect of adverse childhood experiences on depressive symptoms in university students and to verify whether positive psychological resources act as a protective factor for depression. @*Methods@#Data from 1,317 young adults aged 18-29 years who took part in the university-based cross-sectional survey were analyzed. All participants completed self-report questionnaires that included demographic variables, the Adverse Childhood Experience (ACE) Scale, the Patient Health Questionnaire-9, and the Positive Resources Test. @*Results@#The incidence of depression was 33.3% and was higher in women than in men. Based on the 10 ACE categories, 32.7% of the students reported one or more adverse childhood experiences, and 14.4% reported two or more forms of adverse childhood experiences. Students with depressive symptoms were likely to report more traumatic experiences in childhood and fewer positive psychological resources than those without depressive symptoms. Hierarchical regression analysis indicated that positive psychological resources moderated the relationship between adverse childhood experiences and depression. @*Conclusion@#Based on these results, professionals should consider identifying adverse childhood experiences early and provide active mental health service support, including positive psychological and social resources for individuals who have adverse experiences during childhood.
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Objectives@#There has been increased use of medications in treating depressive disorders.Nowadays, patient value is an important part of prescribing medications. This study examines depressive patients’ perspectives on the side effects of medications. @*Methods@#We administered questionnaires nationwide to 364 patients with depressive disorders. Intent or willingness to endure 21 side effects from the Antidepressant Side-Effect Checklist (ASEC) were examined and compared in patients who are less than mildly ill and who are more than moderately ill. @*Results@#In the population, decreased appetite, yawning, increased body temperature, dry mouth, sweating, and constipation are regarded as generally endurable side effects. In contrast, dizziness, light-headedness, nausea or vomiting, headaches, disorientation, problems with urination, and difficulty sleeping are hard to endure. There were differences between patients who are less than mildly ill and those who are more than moderately ill regarding the willingness to endure drowsiness, decreased appetite, sexual dysfunction, palpitations, and weight gain. @*Conclusion@#This nationwide study revealed a general willingness in depressed patients to endure side effects. Sensitive and premeditative discussions of patient value with regard to medications might contribute to finding successful treatments.
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Objective@#The purpose of this study was to explore the accuracy of expectation of medical lethality and to identify characteristics related to high medical lethality in suicide attempters. @*Methods@#A total of 370 suicide attempters (173 men, 197 women) who visited the emergency department at one university hospital were interviewed. @*Results@#Using the Lethality Scale, 103 (27.8%), 114 (30.8%), and 153 (41.4%) suicide attempters were assigned to the low, medium, and high medical lethality groups, respectively. The medium and high medical lethality groups were older, and reported poorer socioenvironmental conditions, compared with the low lethality group. Higher levels of suicide intent were associated with more lethal attempts but only for those attempters who had accurate expectations of the medical lethality of their attempts. @*Conclusion@#The accuracy of expectations about the likelihood of dying was found to moderate the relationships between suicide intent and medical lethality.
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Background@#To address the high suicide rate in Korea, determining the suicidality risk factors is a key concern in policymaking and prevention. This study aimed to describe the effects of traumatic childhood experiences on suicidality among young adults. @*Methods@#This study included 1,379 subjects from two universities in Jeju, Korea. All participants completed selfadministered questionnaires that included demographic variables, the Adverse Childhood Experiences (ACE) scale to evaluate traumatic childhood experiences, and a Korean version of the Suicide Module of the Mini International Neuropsychiatric Interview to evaluate suicidality. @*Results@#Of the subjects, 33.2% reported experiencing traumatic childhood experiences, and the prevalence of positive suicidality was 21.8%. Regression analyses indicated a significant association between traumatic childhood experiences and positive suicidality after controlling for multiple variables. Furthermore, subjects with positive suicidality were likely to report experiencing more traumatic childhood experiences (p<0.001). After categorizing the subjects into two groups according to ACE score, the positive ACE group showed a higher risk of suicidal ideation (p<0.001, adjusted odds ratio [AOR]=2.09) and suicidal attempt (p<0.001, AOR=4.15) than those negative ACE. @*Conclusion@#Intervention and practical strategies for college students with a history of traumatic childhood experiences must be considered for suicide prevention.
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Background@#There is growing interest in adult attention-deficit hyperactivity disorder (ADHD) because many ADHD children have symptoms that last through adulthood, and adult ADHD has a high risk of comorbid mental disorders. This study examined the prevalence and comorbidities of adult ADHD, with a focus on depression and pathological internet use among Korean college students. @*Methods@#This study included 1358 college students, who were asked to complete self-reporting questionnaires on their characteristics, ADHD symptoms, and related clinical factors. The study analyzed associations between ADHD and depression, anxiety, pathological internet use, and problematic alcohol use. @*Results@#The prevalence rate of ADHD among college students was 5.7%. A significant association was determined between ADHD symptoms and school satisfaction, depression, anxiety, and pathological internet use. Multivariate analysis showed that ADHD symptoms in college students were significantly associated with depression and pathological internet use. @*Conclusion@#The prevalence of ADHD among college students was similar to that of children and adolescents. Moreover, the risk of depression and pathological internet use was high in the ADHD group. Early screening and intervention for ADHD and comorbidities will be required to prevent the negative consequences of the condition and help students adapt in the future.
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Background@#The relationship between a low vitamin D level and depression has been demonstrated repeatedly. We assessed the correlation between vitamin D status and the prevalence of depression according to body weight status. @*Methods@#Data from 1,747 participants who took part in the 2014 Korean National Health and Nutrition Examination Survey were analyzed. The presence of depression was identified by the brief, self-reported Patient Health Questionnaire-9 (PHQ-9), vitamin D status was defined based on the serum 25-hydroxyvitamin D [25(OH)D] level, and body weight status was expressed as the body mass index. @*Results@#After adjusting for potential confounding factors, participants in the vitamin D deficiency group (odds ratio [OR], 2.70; 95% confidence interval [CI], 1.01-7.20) and severe deficiency group (OR, 2.89; 95% CI, 1.04-8.00) were significantly more likely to experience depression. Multivariate logistic regression analyses indicated that among the participants with overweight or obesity, those in the vitamin D deficiency group were 3.71 times more likely than those in the sufficiency group (OR, 3.71; 95% CI, 1.08-12.74) to experience depression. @*Conclusion@#Our findings suggest a significant association between low vitamin D levels and depression in adults with overweight or obesity. Further studies are needed to elucidate the association between vitamin D status and depression according to body weight status.
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Objective@#The relationship among physical functional decline, low-grade inflammation, and depression remains unclear. The aim of this study was to examine the association between hand grip strength (HGS) and high-sensitivity C-reactive protein (hs-CRP) in a large sample with depression. @*Methods@#This study used data obtained from a representative Korean sample of 9,402 people who participated in the seventh Korean National Health and Nutrition Examination Survey. Physical function was assessed using a digital grip strength dynamometer. Depression was identified using a cutoff of 5 on the Patient Health Questionnaire-9 (PHQ-9), and high hs-CPR level was defined as ≥ 3.0 mg/L. @*Results@#In older adults (≥ 60 years) with depression, 43.8% of those with high hs-CRP levels had low HGS, compared to 21.8% of those with hs-CRP levels ＜ 3.0 mg/L (p = 0.002). Multivariate analysis revealed that, after adjustments for potentially confounding factors, high hs-CRP was independently associated with lower HGS (B = −2.25; 95% confidence interval = −4.49 to −0.02) in older adults with depression, but not in younger or middle-aged adults with depression. @*Conclusion@#These findings suggest a significant correlation between physical functional decline and low-grade inflammation in older adults with depression.
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Objective@#We explored factors associated with health-related quality of life (HRQOL), including socio-demographic and clinical characteristics, in among older people exposed to the Jeju 4·3 incident, and aimed to determine the effects of depression, posttraumatic stress disorder (PTSD) and perceived social support on HRQOL. @*Methods@#We obtained data from 110 survivors and 1,011 immediate family members of the victims of the Jeju April 3 incident (mean age, 75.1 years), and evaluated the relationships of HRQOL with sociodemographic and clinical characteristics including posttraumatic and depressive symptoms, and perceived social support. @*Results@#Poorer physical health, psychological health, social relationships, and environment HRQOL domain scores were strongly associated with older age, being a woman, poor socioeconomic status, and symptoms of depression and PTSD. The regression analyses indicated that, when relevant factors were controlled for, perceived social support moderated the negative association between HRQOL and psychiatric symptoms. @*Conclusion@#Our results suggest the importance of sociodemographic characteristics, in addition to psychiatric symptoms, for understanding HRQOL in older people exposed to the Jeju 4·3 incident. These results have important implications for interventions aiming to improve the HRQOL of the victims of the Jeju 4·3 incident.
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Objectives@#Adverse childhood experiences (ACEs) of mothers may negatively affect the mental health of their offspring. Little is known about the intergenerational effect of maternal ACE on post-traumatic stress disorder (PTSD) in the offspring. This study investigated the impact of maternal ACEs on PTSD in the offspring. @*Methods@#A total of 156 mothers with children aged 13–18 years completed the Diagnostic Interview Schedule for Children (DISC) Predictive Scales to determine the presence of psychiatric disorders in their offspring. The subjects completed the ACE questionnaire and the Early Trauma Inventory Self-Report-Short Form. Multivariable logistic regression was used to analyze the relationship between maternal ACEs and PTSD in the offspring. @*Results@#Of the mothers, 23.7% had at least one ACE, and PTSD was reported in 21.8% of the offspring. The offspring of the mothers in the ACE group had a significantly higher rates of traumatic experiences and PTSD than the offspring of the mothers in the no ACE group. Maternal household dysfunction independently predicted offspring PTSD [odds ratio (OR)=3.008, p=0.05), and three or more maternal ACEs were significantly related to PTSD in the offspring (OR=10.613, p=0.025). @*Conclusion@#Maternal ACEs have a significant impact on the risk of traumatic experiences and PTSD in the offspring. These findings suggest the presence of intergenerational transmissions by which maternal ACEs affect the mental health of the offspring.
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The purpose of this study was to identify characteristics related to high resilience among older people exposed to the Jeju 4·3 incident. A total of 1,121 aged adults were assigned to low, medium, and high resilience groups, and factors associated with low and high resilience were investigated. High resilience was significantly associated with a low prevalence of depression and high levels of life satisfaction and psychosocial support, as well as with younger age, being a man, higher education level, and current employment. The results deepen our understanding of resilience in the aged people who experienced the early life trauma.
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Objectives@#Adverse childhood experiences (ACEs) of mothers may negatively affect the mental health of their offspring. Little is known about the intergenerational effect of maternal ACE on post-traumatic stress disorder (PTSD) in the offspring. This study investigated the impact of maternal ACEs on PTSD in the offspring. @*Methods@#A total of 156 mothers with children aged 13–18 years completed the Diagnostic Interview Schedule for Children (DISC) Predictive Scales to determine the presence of psychiatric disorders in their offspring. The subjects completed the ACE questionnaire and the Early Trauma Inventory Self-Report-Short Form. Multivariable logistic regression was used to analyze the relationship between maternal ACEs and PTSD in the offspring. @*Results@#Of the mothers, 23.7% had at least one ACE, and PTSD was reported in 21.8% of the offspring. The offspring of the mothers in the ACE group had a significantly higher rates of traumatic experiences and PTSD than the offspring of the mothers in the no ACE group. Maternal household dysfunction independently predicted offspring PTSD [odds ratio (OR)=3.008, p=0.05), and three or more maternal ACEs were significantly related to PTSD in the offspring (OR=10.613, p=0.025). @*Conclusion@#Maternal ACEs have a significant impact on the risk of traumatic experiences and PTSD in the offspring. These findings suggest the presence of intergenerational transmissions by which maternal ACEs affect the mental health of the offspring.
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The purpose of this study was to identify characteristics related to high resilience among older people exposed to the Jeju 4·3 incident. A total of 1,121 aged adults were assigned to low, medium, and high resilience groups, and factors associated with low and high resilience were investigated. High resilience was significantly associated with a low prevalence of depression and high levels of life satisfaction and psychosocial support, as well as with younger age, being a man, higher education level, and current employment. The results deepen our understanding of resilience in the aged people who experienced the early life trauma.
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Objective@#We explored factors associated with health-related quality of life (HRQOL), including socio-demographic and clinical characteristics, in among older people exposed to the Jeju 4·3 incident, and aimed to determine the effects of depression, posttraumatic stress disorder (PTSD) and perceived social support on HRQOL. @*Methods@#We obtained data from 110 survivors and 1,011 immediate family members of the victims of the Jeju April 3 incident (mean age, 75.1 years), and evaluated the relationships of HRQOL with sociodemographic and clinical characteristics including posttraumatic and depressive symptoms, and perceived social support. @*Results@#Poorer physical health, psychological health, social relationships, and environment HRQOL domain scores were strongly associated with older age, being a woman, poor socioeconomic status, and symptoms of depression and PTSD. The regression analyses indicated that, when relevant factors were controlled for, perceived social support moderated the negative association between HRQOL and psychiatric symptoms. @*Conclusion@#Our results suggest the importance of sociodemographic characteristics, in addition to psychiatric symptoms, for understanding HRQOL in older people exposed to the Jeju 4·3 incident. These results have important implications for interventions aiming to improve the HRQOL of the victims of the Jeju 4·3 incident.
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Objective@#In this study we investigated whether current mood states of patients with bipolar disorder have an influence on the screening accuracy of the Mood Disorder Questionnaire (MDQ). @*Methods@#A total of 452 patients with mood disorder (including 192 with major depressive disorder and 260 with bipolar disorder completed the Korean version of the MDQ. Patients with bipolar disorder were subdivided into three groups (bipolar depressed only, bipolar euthymic only, bipolar manic/hypomanic only) according to current mood states. The screening accuracy of the MDQ including sensitivity, specificity and area under the curve (AUC) of receiver operating characteristic (ROC) curves were evaluated according to current mood states. @*Results@#The optimal cutoff of MDQ was 5 in this study sample. Sensitivity and specificity were not significantly different according to current mood states. Significant differences in AUCs of four independent ROC curves were not found (ROC 1st curve included all bipolar patients; ROC 2nd curve included only bipolar depressed patients; ROC 3rd curve included only bipolar manic/hypomanic patients; ROC 4th curve included only bipolar euthymic patients). @*Conclusion@#The study results showed that current mood states (either euthymic state, depressed or manic/hypomanic) did not significantly influence the screening accuracy of the MDQ suggesting that the MDQ could be a useful screening instrument for detecting bipolar disorder in clinical practice regardless of the current mood symptoms of subjects.
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Background@#This study aimed to examine the occupational stress and quality of life of mental health welfare center workers and to identify the impact of occupational stress on compassion satisfaction, burnout, and secondary traumatic stress. @*Methods@#This study included 588 employees working at 15 provincial/municipal/regional mental health welfare centers. Demographic and psychosocial factors were surveyed. Data were analyzed using independent t-test, Pearson’s correlation test, and multiple regression analysis. @*Results@#The high-risk group for occupational stress showed low compassion satisfaction, high burnout, and high secondary traumatic stress. Compassion satisfaction showed a significant negative correlation with occupational stress. Burnout and secondary traumatic stress showed a significant positive correlation with occupational stress.Occupational stress factors affecting compassion satisfaction included lack of reward (β=−0.155, p<0.001), whereas those affecting burnout included physical environment (β=0.028, p<0.01), job demand (β=0.042, p<0.001), relationship conflict (β=0.033, p<0.01), job instability (β=0.016, p<0.01), lack of reward (β=0.051, p<0.001), and occupational climate (β=0.024, p<0.01). Additionally, occupational stress factors affecting secondary traumatic stress included physical environment (β=0.063, p<0.001) and job instability (β=0.020, p<0.05). @*Conclusion@#Occupational stress had a significant impact on compassion satisfaction, burnout, and secondary traumatic stress. Therefore, active interventions against occupational stress factors are necessary to improve the quality of life of mental health welfare center workers.
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Background@#The Internet has become an important global tool used by diverse age groups, especially adolescents and young adults. However, in South Korea, studies on the prevalence of pathological Internet use (PIU) among college students are limited to being compared with those involving adolescents. Therefore, in this report, we assessed the pervasiveness of PIU and its related factors among college students. @*Methods@#Data were collected from 1,390 college students. PIU was screened using the Self-Report Scale for Measuring Behavior Symptoms of Adults’ PIU. We analyzed the associations between PIU and depression, anxiety, and suicidality. We also used the self-report questionnaire to assess sociodemographic and other clinical factors. @*Results@#Of the total number of participants, 16.8% (n=234) were identified as problematic Internet users. Univariate analysis revealed significant associations between depression, anxiety, suicidal behavior, and PIU. Multivariate analysis further showed a significant relation between unsatisfactory school life (odds ratio [OR], 2.56; 95% confidence interval [CI], 1.06-6.15; p=0.036), depression (OR, 1.67; 95% CI, 1.03-2.71; p=0.036), and anxiety (OR, 3.36; 95% CI, 1.91-5.93; p<0.001) with PIU. @*Conclusion@#Depression, anxiety, and suicidality are common in individuals engaged in PIU, with a complex interrelation. Further studies are required to clarify the mechanisms of PIU and develop preventive and treatment strategies.