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Objective@#The suicide rate in Korea was the highest among countries in the Organisation for Economic Co-operation and Development in 2019. In a previous study, higher intake of vegetables and fruits was associated with a lower risk of suicidal ideation, and carotene-rich fruits and vegetables lowered the risk of depression. This study aimed to examine the direct relationship between carotene intake and suicidal ideation, adjusting for the effect on depression. @*Methods@#This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 2012, 2013, and 2015. Carotene intake was assessed through a food intake frequency survey with a 24-hour recall. Suicidal ideation and depression were assessed using the mental health section of the KNHANES. We applied logistic regression to assess the relationship between carotene intake and suicidal ideation, adjusting for potential confounders. @*Results@#A total of 5,480 females aged 19–64 years were included in this study. Carotene intake was significantly lower in the suicidal ideation group (3,034.5±1,756.4 μg/day) than in the nonsuicidal ideation group (3,225.4±1,795.1 μg/day) (p=0.015). We found a significant inverse association between carotene intake and the risk of suicidal ideation after adjusting for potential confounders (odds ratio=0.934, 95% confidence interval=0.873–0.999). @*Conclusion@#These results suggest that carotene intake may be inversely associated with the risk of suicidal ideation. Our findings may inform the development of new nutritional interventions to prevent increases in the risk of suicide worldwide.
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Objectives@#The aim of this study was to investigate temperament and character associated with resilience in patients with bipolar disorder (BD). @*Methods@#A total of 55 outpatients diagnosed with BD according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), and 55 healthy controls matched by age and sex with the BD group were recruited.All participants completed the Connor-Davidson Resilience Scale (CD-RISC) and Temperament and Character Inventory (TCI). Multiple linear regression analysis was performed by controlling for age, length of education, age of onset, number of depressive episodes, and number of hospitalizations to determine factors related to resilience. In addition, multiple regression analysis was performed using the interaction term to investigate whether temperament and character associated with resilience differed between the two groups. @*Results@#Patients with BD showed higher harm avoidance (p<0.001) and lower self-directedness (p<0.001) among the TCI dimensions compared to the control group. In multiple regression analysis, harm avoidance (β=-0.274, p=0.025) and self-directedness (β=0.431, p=0.002) were associated with resilience in patients with BD, while harm avoidance (β=-0.411, p=0.008), persistence (β=0.244, p=0.031), and cooperativeness (β=0.264, p=0.037) were associated with resilience in the control group. Self-directedness had a different relationship with resilience between the two groups (β=0.212, p=0.001). @*Conclusions@#The findings suggest that BD patients’ particular temperament and character are associated with resilience.Furthermore, temperament and character related to resilience differed between the BD group and the control group.
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Objectives@#Following the coronavirus disease 2019 (COVID-19) pandemic, adolescents have experienced decreased physical activity and a decline in mental health. This study analyzed the association between changes in depressed mood after the COVID-19 pandemic and physical activity among adolescents. @*Methods@#The analysis was based on the results of the 17th Youth Health Behavior Online Survey conducted in 2021, which included 54848 middle and high school students in South Korea. Information on physical activity included low-intensity physical activity lasting >60 min/day, high-intensity physical activity, and strength training exercises. A logistic regression analysis was performed to evaluate the association between physical activity and changes in depression after the COVID-19 pandemic. @*Results@#After adjusting for sociodemographic characteristics and previous depression, adolescents who performed strength training exercises more than once per week had a 0.95-fold lower risk (odds ratio [OR]=0.948, 95% confidence interval [CI]=0.905–0.994, p= 0.027) of increasing depression after the COVID-19 pandemic, while the risk of decreasing depression increased by 1.22-fold (OR=1.215, 95% CI=1.131–1.305, p60 min/day and high-intensity physical activity. @*Conclusion@#Strength-training exercises are significantly associated with the prevention of depression among adolescents following the COVID-19 pandemic.
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Objectives@#：Suicide is a global social problem. Social burden caused by suicide is gradually increasing. Various efforts have been made to prevent suicide. Lifestyle changes to western style, especially diet changes, have increased the risk for suicide. Therefore, in this study, we discussed diet as an adjuvant treatment for suicide. @*Methods@#：In this review, we summarized the biochemical mechanism of suicide, and diet as a risk factor for suicide and diet as a protective factor through a web search. @*Results@#：In this study, biochemical mechanisms for suicide were reviewed and diet as a risk factor and diet as a protective factor for suicide were investigated. It was confirmed that neurotoxic effects such as oxidative stress and inflammation in the neural system could increase the risk of suicide. Based on results of previous stud-ies on the relationship between suicide and diet, it was found that heavy use of alcohol, coffee, carbonated soft drink, and fast food were risk factors for suicide. Protective factors for suicide included antioxidants such as vitamin C, carotene, and anti-inflammatory agents such as omega-3 fatty acids found in seafood in large amounts. @*Conclusions@#：The only treatment for suicide is prevention. In this context, effectiveness, accessibility, and safety are important for preventing for suicide. Antioxidants and anti-inflammatory agents that are relatively safe and readily available to the public could be effective adjuvant treatments to decrease the risk of suicide. In addition, it is necessary to educate the public on reducing diets that could increase the risk of suicide
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Objectives@#Our study aimed to investigate the relationship between the anxiety at first year and chronotype and sleep quality at third year in medical students. We also investigated the association between sleep quality, chronotype, depression and resilience at third year. @*Methods@#Fifty two medical students (36 males, 69%, aged 21 ± 0.93) in first year, and forty four medical students (31 males, 70.5%, aged 23.05 ± 0.99) at third year answered Beck Depression Inventory 2, Beck anxiety inventory, Insomnia severity index-K, Composite scale of morningness and Conner-Davidson Resilience scale-10. Multiple linear regression analysises were performed to identify predictors of chronotype, sleep quality and resilience. @*Results@#Higher anxiety (β = -0.434, p = 0.006) at first year was significant predictor of eveningness at third year, while lower anxiety score (β = 0.606, p < 0.001) at first year was significant predictor of sleep quality at third year. Lower sleep quality (β = -0.314, p = 0.042) and eveningness (β = 0.315, p = 0.041) were associated with low resilience at third year. Also, Lesser depression (β = -0.717, p < 0.001) was associated with higher resilience at third year. @*Conclusion@#Our study showed that higher anxiety in first year had significantly related with eveningness and poor sleep quality at third year. In addition, higher sleep quality, morningness and less depression had significantly associated with better resilience at third year.
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Objectives@#：The purpose of this study was to investigate the relationship between serum vitamin D concentration and resilience in patients hospitalized with bipolar disorder. @*Methods@#：Serum vitamin D levels were measured on day 1 of hospitalization in 64 patients with bipolar disorder, who were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. The ConnorDavidson Resilience Scale and the Korean version of the Inventory for Depressive Symptomatology (KIDS) were administered to these patients, and symptoms of mania were evaluated using the Young Mania Rating Scale (YMRS). Patients were then categorized into vitamin D sufficient and deficient groups based on a serum vitamin D cut-off of 20 ng/ mL. Analysis of covariance (ANCOVA) was performed to compare the resilience between the two groups, and multiple linear regression was performed to determine the association between serum vitamin D levels and resilience. @*Results@#：The vitamin D deficiency group had more depressive episodes than the sufficient group (p<0.05). ANCOVA showed that the vitamin D deficient group had significantly lower resilience scores than the sufficient group (p= 0.034). Moreover, multiple regression analyses conducted by controlling age, sex, body mass index, season of blood sampling, KIDS scores, and YMRS scores, showed a significant association between serum vitamin D concentration and resilience in patients with bipolar disorder (p=0.001). @*Conclusions@#：This study suggested that vitamin D deficiency is associated with resilience as a protective factor against stress and trauma in patients with bipolar disorder. Further research is warranted to determine the causal relationship between vitamin D levels and resilience.
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Purpose@#The purpose of this study is to compare the color stability of provisional restorative materials fabricated by subtractive and additive manufacturing. @*Materials and Methods@#PMMA specimens by subtractive manufacturing and conventional method and bis-acryl specimens by additive manufacturing were fabricated each 20. After immersing specimens in the coffee solution and the wine solution, the color was measured as CIE Lab with a colorimeter weekly for 4 weeks. Color change was calculated and data were analyzed with one-way ANOVA and the Tukey multiple comparisons test (α = 0.05). @*Results@#PMMA provisional prosthetic materials by subtractive manufacturing showed superior color stability compared to bis-acryl provisional prosthetic materials by additive manufacturing (P 0.05). @*Conclusion@#It is recommended to fabricate provisional restorations by subtractive manufacturing in areas where esthetics is important, such as anterior teeth, and consideration of the color stability will be required when making provisional prosthetic using additive manufacturing.
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Objective@#This study investigated the types of daily life stressors associated with social media use in adolescents with problematic Internet/smartphone use in a city in Korea. @*Methods@#Data from 2,997 Internet and smartphone users who participated in a survey about the actual use of smart digital media in Korea were included. The measurement tools included questionnaires on Internet and smartphone usage patterns and types of daily life stressors as well as the Internet Gaming Use-Elicited Symptom Screen and a smartphone addiction scale. The subjects were divided into a problematic Internet/smartphone use group and a control group. We compared the types of daily life stressors associated with social media use for each group. @*Results@#All types of daily life stressors were more prevalent in the problematic Internet use group than in the control group. In the problematic Internet/smartphone use group, the types of daily life stressors that were positively associated with social media use were sibling rivalry and physical health. In the control group, social media use was negatively associated with daily life stressors related to appearance and heterosexual relationships. @*Conclusion@#There is a need to provide personalized stress management related to social media use for adolescents with problematic Internet/smartphone use.
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Objectives@#Adolescent suicide is a serious social problem. Adolescent alcohol use is one of the most important risk factors for adolescent suicide. This study aimed to identify the relationship between drinking habits and suicide among Korean adolescents. @*Methods@#Data from the 14th and 15th Korean Youth Risk Behavior Web-based Survey, conducted in 2018 and 2019, were used for analysis. Multiple logistic regression analysis was used to identify the relationship between drinking habits—including the age of drinking initiation, frequency of drinking, average drinking amount, frequency of drunkenness—and suicidal ideation, plans, and attempts. @*Results@#Even after adjusting for age, sex, school grade, academic achievement, socioeconomic status, depression, stress, and drinking habits, the frequencies of drinking and drunkenness increased the risk of suicide attempts. Suicide attempts were associated with the frequency of drinking in girls and middle school students, and with the frequency of drunkenness in boys and high school students. @*Conclusion@#This study identified associations between drinking habits (the age of drinking initiation, frequency of drinking, average amount of drinking, frequency of drunkenness) and suicidal behavior in adolescents. Our findings suggest that to prevent adolescent suicide, it might be necessary to investigate drinking habits, including the frequencies of drinking and drunkenness. Moreover, considering the differences in sex and school grade, it is important to include the individual group characteristics when evaluating drinking habits.
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Background@#Puberty is a biologically and psychologically unstable period, and pubertal changes differ by sex. However, most previous studies on pubertal timing and suicide have focused on girls. This study investigated the association between early spermarche and suicide attempts in boys. @*Methods@#We analyzed a nationally representative sample of Korean adolescents (The Korea Youth Risk Behavior Web-Based Survey, KYRBS) that included approximately 35,000 boys annually from 2011 to 2015. Pubertal timing in boys was defined by spermarche. Complex sampling logistic regression analyses were performed to evaluate the odds ratios (ORs) for suicide attempts between the early and average spermarche groups. @*Results@#The ORs for suicide attempts in boys with early spermarche were significantly higher than those in boys with average spermarche after adjustment for age, perceived stress, depressive symptoms, and suicidal ideation. The ORs from 2011 to 2015 were as follows: 1.782 (P < 0.001), 1.490 (P = 0.002), 1.693 (P < 0.001), 1.541 (P = 0.001), and 1.393 (1.024– 1.895; P = 0.035), respectively. @*Conclusion@#These findings suggest that early pubertal timing is a risk factor for suicide attempts in Korean boys after adjustment for depressive symptoms, perceived stress, and suicidal ideation, which have been previously reported as risk factors for suicide attempts. Therefore, careful attention should be paid to the prevention of suicide in boys who experience early spermarche in Korea.
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Objective@#To investigate perceptions of coronavirus disease-19 (COVID-19) associated with anxiety caused by the COVID-19 epidemic in the elderly who are vulnerable to mental health problems. @*Methods@#This study used data of a survey on perceptions of COVID-19 and changes in mental health of 1,000 out of residents in a province of Korea in April 2020. The survey included questions about psychological perceptions for COVID-19. Subjects were dived into two groups (<60 and ≥60). Binary logistic regression analyses were performed for evaluating the association between anxiety and perceptions about COVID-19 in each group. @*Results@#Results of binary logistic regression analyses revealed that only ‘fear of getting infected myself’among perceptions for COVID-19 was associated with anxiety in the elderly aged more than 60 years. However, in adults aged less than 60 years, all perceptions for COVID-19 except impairment of performance were associated with such anxiety. @*Conclusion@#We found that the anxiety for COVID-19 in elderly with age over 60 years was associated with ‘fear of getting infected myself’ rather than ‘fear of family or people around them’, unlike adults aged less than 60 years. These results can be applied in strategies for psychological quarantine against COVID-19 among the elderly.
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Objectives@#Adolescent suicide is a serious social problem. Adolescent alcohol use is one of the most important risk factors for adolescent suicide. This study aimed to identify the relationship between drinking habits and suicide among Korean adolescents. @*Methods@#Data from the 14th and 15th Korean Youth Risk Behavior Web-based Survey, conducted in 2018 and 2019, were used for analysis. Multiple logistic regression analysis was used to identify the relationship between drinking habits—including the age of drinking initiation, frequency of drinking, average drinking amount, frequency of drunkenness—and suicidal ideation, plans, and attempts. @*Results@#Even after adjusting for age, sex, school grade, academic achievement, socioeconomic status, depression, stress, and drinking habits, the frequencies of drinking and drunkenness increased the risk of suicide attempts. Suicide attempts were associated with the frequency of drinking in girls and middle school students, and with the frequency of drunkenness in boys and high school students. @*Conclusion@#This study identified associations between drinking habits (the age of drinking initiation, frequency of drinking, average amount of drinking, frequency of drunkenness) and suicidal behavior in adolescents. Our findings suggest that to prevent adolescent suicide, it might be necessary to investigate drinking habits, including the frequencies of drinking and drunkenness. Moreover, considering the differences in sex and school grade, it is important to include the individual group characteristics when evaluating drinking habits.
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Background@#Puberty is a biologically and psychologically unstable period, and pubertal changes differ by sex. However, most previous studies on pubertal timing and suicide have focused on girls. This study investigated the association between early spermarche and suicide attempts in boys. @*Methods@#We analyzed a nationally representative sample of Korean adolescents (The Korea Youth Risk Behavior Web-Based Survey, KYRBS) that included approximately 35,000 boys annually from 2011 to 2015. Pubertal timing in boys was defined by spermarche. Complex sampling logistic regression analyses were performed to evaluate the odds ratios (ORs) for suicide attempts between the early and average spermarche groups. @*Results@#The ORs for suicide attempts in boys with early spermarche were significantly higher than those in boys with average spermarche after adjustment for age, perceived stress, depressive symptoms, and suicidal ideation. The ORs from 2011 to 2015 were as follows: 1.782 (P < 0.001), 1.490 (P = 0.002), 1.693 (P < 0.001), 1.541 (P = 0.001), and 1.393 (1.024– 1.895; P = 0.035), respectively. @*Conclusion@#These findings suggest that early pubertal timing is a risk factor for suicide attempts in Korean boys after adjustment for depressive symptoms, perceived stress, and suicidal ideation, which have been previously reported as risk factors for suicide attempts. Therefore, careful attention should be paid to the prevention of suicide in boys who experience early spermarche in Korea.
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Objective@#To investigate perceptions of coronavirus disease-19 (COVID-19) associated with anxiety caused by the COVID-19 epidemic in the elderly who are vulnerable to mental health problems. @*Methods@#This study used data of a survey on perceptions of COVID-19 and changes in mental health of 1,000 out of residents in a province of Korea in April 2020. The survey included questions about psychological perceptions for COVID-19. Subjects were dived into two groups (<60 and ≥60). Binary logistic regression analyses were performed for evaluating the association between anxiety and perceptions about COVID-19 in each group. @*Results@#Results of binary logistic regression analyses revealed that only ‘fear of getting infected myself’among perceptions for COVID-19 was associated with anxiety in the elderly aged more than 60 years. However, in adults aged less than 60 years, all perceptions for COVID-19 except impairment of performance were associated with such anxiety. @*Conclusion@#We found that the anxiety for COVID-19 in elderly with age over 60 years was associated with ‘fear of getting infected myself’ rather than ‘fear of family or people around them’, unlike adults aged less than 60 years. These results can be applied in strategies for psychological quarantine against COVID-19 among the elderly.
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Objective@#This study investigated the types of daily life stressors associated with social media use in adolescents with problematic Internet/smartphone use in a city in Korea. @*Methods@#Data from 2,997 Internet and smartphone users who participated in a survey about the actual use of smart digital media in Korea were included. The measurement tools included questionnaires on Internet and smartphone usage patterns and types of daily life stressors as well as the Internet Gaming Use-Elicited Symptom Screen and a smartphone addiction scale. The subjects were divided into a problematic Internet/smartphone use group and a control group. We compared the types of daily life stressors associated with social media use for each group. @*Results@#All types of daily life stressors were more prevalent in the problematic Internet use group than in the control group. In the problematic Internet/smartphone use group, the types of daily life stressors that were positively associated with social media use were sibling rivalry and physical health. In the control group, social media use was negatively associated with daily life stressors related to appearance and heterosexual relationships. @*Conclusion@#There is a need to provide personalized stress management related to social media use for adolescents with problematic Internet/smartphone use.
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Objectives@#Sleep disturbance in the elderly is associated with cognitive decline. Sleep quality is known to deteriorate with age, and prospective studies seldom have examined the relationship between sleep quality and cognitive function. This study investigates the relationship between early sleep quality and cognitive function based on six-year follow-up data of community individuals older than 60 years. @*Methods@#The participants included 622 community elderly people older than 60 years from Jinju-Si. The final analysis comprised 322 elderly people. Pittsburgh sleep quality index (PSQI) and the Korean version of Consortium to Establish a Registry for Alzheimer’s Disease (CERAD-K) were used to assess early sleep quality and cognitive function after six years. Multiple linear regression analysis was performed to investigate the association between early sleep quality and cognitive function in the elderly. @*Results@#Early sleep quality (PSQI) was significantly associated with the results of the digit span test, clock drawing test (clox 1), and word recall test after six years. Sleep quality (PSQI) decreased significantly after six years, and lower quality of sleep (PSQI) score was associated with higher digit span test score (β = -0.167, p = 0.026) and higher clock drawing test score (β = -0.157, p = 0.031). Lower quality of sleep (PSQI) score was associated with higher word recall test (β = -0.140, p = 0.039). @*Conclusion@#The digit span test, word recall test, and clock drawing task (CLOX 1) shown to be significantly associated to sleep quality can be performed fast and easily in clinical practice. It is important to assess early cognitive function in the elderly with poor sleep quality, and further studies could suggest that these tests may be useful screening tests for early dementia in elderly with poor sleep quality.
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Objective@#There have been many biological studies on suicide behaviors of borderline personality disorder (BPD), however few studies have sought to psychoanalytic characteristics including defense mechanisms. Therefore, we investigated psychological, symptomatic, and personality characteristics including defense mechanisms in suicide attempters and non-suicide attempters among patients with BPD. @*Methods@#We enrolled 125 patients with BPD. Forty-two patients with a history of one or more suicide attempts formed the suicide attempters group and 83 patients with no such history formed the non-suicide attempters group. We collated the differences in clinical and psychological characteristics between the two groups by using the Symptom Checklist-90-Revised (SCL-90-R), the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), the Personality Disorder Questionnaire-4+ (PDQ-4+), and the Defense Style Questionnaire (DSQ). @*Results@#The suicide attempters group scored higher on the hostility subscale of SCL-90-R. The suicide attempters group also scored higher on the Infrequency, Back Infrequency, Lie, Masculinity-femininity, Paranoia, Psychasthenia, and Schizophrenia scales of the MMPI-2. The incidence of paranoid and antisocial personality disorders, as assessed by the PDQ-4+, was significantly different in both groups. Maladaptive, self-sacrificing defense style, splitting and affiliation on the DSQ were also higher for the suicide attempters group. In the results of the logistic regression analysis, gender, the F(B) and L scales on the MMPI-2, and ‘splitting of other’s image’ defense mechanism on the DSQ were the factors that significantly influenced to suicide attempts. @*Conclusion@#These findings suggest that impulsive psychiatric features and maladaptive defense style may be related to suicidal risk in patients with BPD. Therefore, our findings may help clinicians in estimating the risk of suicide in patients with BPD.
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The purpose of this study was to evaluate the mediating effect of depressive symptoms on the relationship between adverse childhood experiences (ACEs) and problematic internet use. The study participants were 180 students between the ages of 9 and 18 years. Path analysis was performed to measure the relationships among ACEs, depressive symptoms and problematic internet use. ACEs significantly affected depressive symptoms (standardized regression weight, 0.36; P < 0.01), and depressive symptoms also affected problematic internet use (standardized regression weight, 0.40; P < 0.01). We found that depressive symptoms had a significant mediating effect on the relationship between problematic internet use and ACEs. The management of depressive symptoms would be important to prevent problematic internet use in children and adolescents with ACEs.
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Objectives@#：Suicide attempt history is one of the major suicide risk factors and the suicide mortality rate increases with the number of suicide attempts. This study aimed to compare demographic and clinical factors between first and multiple suicide attempters and investigate risk factors for multiple suicide attempts. @*Methods@#：Participants were 537 patients who were admitted to an emergency room after attempting suicide and divided into two groups (393 first attempters and 144 multiple attempters). Demographic factors, clinical characteristics, and suicide-related characteristics were compared between the two groups. Variables with a p-value lower than 0.1 were included in a multivariate logistic regression analysis. Logistic regression models were considered to identify independent risk factors for multiple suicide attempts. The significance level was set to 0.05. @*Results@#：Among demographic factors, the two groups differed in age, sex, education, occupation, and marital and cohabitation status. Multiple attempters were more likely to have a mental disorder, current use of psychiatric medication, interpersonal and psychiatric motivation for suicide, current suicidal thoughts, help seeking behavior, awareness of suicide, and agreement with psychiatric follow up. In the regression analysis, unmarried status, mental disorder, interpersonal or psychiatric stress, help seeking behavior, and antidepressant use emerged as significant risk factors of multiple suicide attempts. @*Conclusion@#：The study’s findings suggested that there are differences in the demographic and clinical characteristics of first and multiple suicide attempters. Specific strategies that consider unmarried status, mental disorder, interpersonal or psychiatric stress, help seeking behavior, and antidepressant use may be valuable for future suicide prevention.
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Objectives@#：Suicide attempt history is one of the major suicide risk factors and the suicide mortality rate increases with the number of suicide attempts. This study aimed to compare demographic and clinical factors between first and multiple suicide attempters and investigate risk factors for multiple suicide attempts. @*Methods@#：Participants were 537 patients who were admitted to an emergency room after attempting suicide and divided into two groups (393 first attempters and 144 multiple attempters). Demographic factors, clinical characteristics, and suicide-related characteristics were compared between the two groups. Variables with a p-value lower than 0.1 were included in a multivariate logistic regression analysis. Logistic regression models were considered to identify independent risk factors for multiple suicide attempts. The significance level was set to 0.05. @*Results@#：Among demographic factors, the two groups differed in age, sex, education, occupation, and marital and cohabitation status. Multiple attempters were more likely to have a mental disorder, current use of psychiatric medication, interpersonal and psychiatric motivation for suicide, current suicidal thoughts, help seeking behavior, awareness of suicide, and agreement with psychiatric follow up. In the regression analysis, unmarried status, mental disorder, interpersonal or psychiatric stress, help seeking behavior, and antidepressant use emerged as significant risk factors of multiple suicide attempts. @*Conclusion@#：The study’s findings suggested that there are differences in the demographic and clinical characteristics of first and multiple suicide attempters. Specific strategies that consider unmarried status, mental disorder, interpersonal or psychiatric stress, help seeking behavior, and antidepressant use may be valuable for future suicide prevention.