Time-Series Trends of Depressive Levels of Korean Adults During the 2020 COVID-19 Pandemic in South Korea

Objective@#This study aimed to observe the changes in people’s depressive levels over 9 months since the coronavirus disease of 2019 (COVID-19) outbreak as well as to identify the predictors of people’s depressive levels including COVID-19 infection fear in the context of South Korea in 2020. @*Methods@#For these purposes, four cross-sectional surveys were periodically implemented from March to December 2020. We randomly recruited 6,142 Korean adults (aged 19 to 70) by using a quota survey. Along with descriptive analysis, which included a one-way analysis of variance and correlations, multiple regression models were built to identify the predictors of people’s depressive levels during the pandemic. Results Overall, people’s depressive levels and fear of COVID-19 infection gradually increased since the COVID-19 outbreak. In addition to demographic variables (i.e., being a female, young age, unemployed, and living alone) and the duration of the pandemic, people’s COVID-19 infection fear was associated with their depressive levels. @*Conclusion@#To ameliorate these rising mental health issues, access to mental health services should be secured and expanded, particularly for individuals who present greater vulnerabilities due to socioeconomic characteristics that may affect their mental health.

COVID-19 Pandemic-Related Job Loss Impacts on Mental Health in South Korea

Objective@#The economic hardship brought by the coronavirus disease-2019 (COVID-2019) pandemic has caused mental health problems among people of different socioeconomic status (SES). As social support helps to buffer these problems, we investigated the association between job loss related to COVID-19 and depression, anxiety, and suicidal thoughts; the differences in the effects according to SES; and the mediating effects of social support. @*Methods@#The effects of COVID-19-related job loss on depression, anxiety, and suicidal thoughts among 1,364 people were investigated through semi-structured and self-administered questionnaires: Patient Health Questionnaire–9, General Anxiety Disorder–7, and the Functional Social Support Questionnaire. Logistic regression and subgroup analyses were performed to assess the association between job loss and mental health status, and the moderating effects of income and educational levels. Moreover, the mediating effects of perceived social support on the association between job loss and depression, anxiety, and suicidal thoughts were analyzed. @*Results@#COVID-19-related job loss increased the risk of depression and suicidal thoughts. Adults with lower income and education level were at higher risk of depression, anxiety, and suicidal thoughts; perceived social support level had significant mediating effects on the association between job loss and depression/anxiety; and income level had significant moderating effects on this mediating pathway. @*Conclusion@#COVID-19-related job loss were likely to be significantly associated with negative mental health outcomes, especially among individuals with low income and education levels. As social support had buffering effects on such outcomes, related government policies in cooperation with the governance of communities and stakeholders must be prepared.

Factors Related to Anxiety and Depression Among Adolescents During COVID-19: A Web-Based CrossSectional Survey

Background@#The coronavirus disease 2019 (COVID-19) outbreak and subsequent disease-containment measures (such as school closures) significantly affected the lives of adolescents. We evaluated the mental-health status and factors associated with anxiety and depression among South Korean adolescents. @*Methods@#A nationwide online survey was conducted to evaluate the mental-health status of South Korean adolescents during the COVID-19 pandemic. In total, 570 adolescents aged 13–18 years were surveyed between May 27 and June 11, 2021. The participants completed the Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire (PHQ-9) to determine anxiety and depression symptoms, respectively. Stepwise logistic regression models were constructed to determine factors related to anxiety and depression. @*Results@#Among the study participants, 11.2% and 14.2% had anxiety and depression, respectively. The results suggested that several factors, such as the experience of COVID-19 infection and quarantine of oneself, a family member or an acquaintance, physical and mental health problems, and fear of one’s local community being discriminated against as a COVID-19 area were related to anxiety and depression. @*Conclusion@#The present study identified COVID-19-related factors associated with anxiety and depression among adolescents, and provides insights regarding potential interventions to improve the mental health of adolescents. To promote the mental health of adolescents during the COVID-19 pandemic, special attention should be paid to individuals with physical or mental-health problems, and efforts should be made to reduce the negative social and emotional impacts of infection-control measures.

COVID-19 and Risk Factors of Anxiety and Depression in South Korea

Objective@#The aims of this study were to explore the prevalence of and identify predictors of anxiety and depression related to coronavirus disease of 2019 (COVID-19) in South Korea. @*Methods@#The analysis is based on a quota survey design and a sampling frame that permitted recruitment of a national sample of 1,014 individuals between March 17–31, 2020. Several standardized measurements were used, including GAD-7, PHQ-9, COVID-19 related fear, restrictions in deaily life, as well as sociodemographic information and physical and psychosocial needs during the pandemic. Multiple logistic regression was conducted to analyze the influence of sociodemographic factors, fear, and physical/psychosocial needs on anxiety and depression. @*Results@#Significant numbers of the respondents were identifiable anxiety (19.0%) and depression group (17.5%), respectively. This indicates that the depression and anxiety prevalence rate after the COVID-19 is substantially high compared to the depression rate of 2.6% in 2020 and 2.8% in 2018 both reported in the Korea Community Health Survey and the anxiety rate of 5.7% reported in 2016 Survey of Mental Disorders in Korea. Multiple logistic regression results showed age, COVID-19 related fear, and the level of restrictions in daily as significant factors in understanding and predicting the anxiety group. Likfewise, the COVID-19 related fear, restrictions in daily life, and need for economic support were important predictors in predicting the depression group. @*Conclusion@#Findings on predictors for greater vulnerability to anxiety and depression has important implications for public mental health in the context of the COVID-19 pandemic.

COVID-19 and Risk Factors of Anxiety and Depression in South Korea

Objective@#The aims of this study were to explore the prevalence of and identify predictors of anxiety and depression related to coronavirus disease of 2019 (COVID-19) in South Korea. @*Methods@#The analysis is based on a quota survey design and a sampling frame that permitted recruitment of a national sample of 1,014 individuals between March 17–31, 2020. Several standardized measurements were used, including GAD-7, PHQ-9, COVID-19 related fear, restrictions in deaily life, as well as sociodemographic information and physical and psychosocial needs during the pandemic. Multiple logistic regression was conducted to analyze the influence of sociodemographic factors, fear, and physical/psychosocial needs on anxiety and depression. @*Results@#Significant numbers of the respondents were identifiable anxiety (19.0%) and depression group (17.5%), respectively. This indicates that the depression and anxiety prevalence rate after the COVID-19 is substantially high compared to the depression rate of 2.6% in 2020 and 2.8% in 2018 both reported in the Korea Community Health Survey and the anxiety rate of 5.7% reported in 2016 Survey of Mental Disorders in Korea. Multiple logistic regression results showed age, COVID-19 related fear, and the level of restrictions in daily as significant factors in understanding and predicting the anxiety group. Likfewise, the COVID-19 related fear, restrictions in daily life, and need for economic support were important predictors in predicting the depression group. @*Conclusion@#Findings on predictors for greater vulnerability to anxiety and depression has important implications for public mental health in the context of the COVID-19 pandemic.

Effect of Korean Version of Psychological First Aid Training Program on Training Disaster Mental Health Service Provider / 신경정신의학

Objectives@#This study aimed to develop a Korean version of psychological first aid training program (K-PFA) and examine the education effect on trainees. @*Methods@#This study enrolled 485 subjects who completed both K-PFA and study surveys. In addition to mental health professionals, subjects with various ages and educational backgrounds were included to examine the education effects of the capabilities in conducting PFA and understanding acute phase disaster mental health (DMH). @*Results@#Both mental health professionals and non-professionals improved their understanding of acute-phase DMH intervention and their perceived capabilities in conducting PFA. @*Conclusion@#The development of a DMH intervention-training program adapted to Korean domesticcircumstances and culture represents a significant step towards a comprehensive and individualized intervention for disaster survivors.

The Development and Validation of the Perceived Competence Scale for Disaster Mental Health Workforce

OBJECTIVE: This study was conducted to validate a Perceived Competence Scale for Disaster Mental Health Workforce (PCS-DMHW) designed to measure the core competences of mental health workers in disaster response situations at individual and organizational levels. core competences essentially required in disaster response situations were defined on the basis of literature review, focus-group interview with disaster response professionals, and expert judgment.METHODS: The preliminary items of the PCS-DMHW thus generated were administered to 509 participants consisted of mental health professionals and semi-professionals. The data retrieved from questionnaires were equally divided by two halves. The final items were determined through the exploratory factor analysis of the half data (n=255), and the construct validity was tested by performing the confirmatory factor analysis and criterion-related validity test of the remaining half data (n=254).RESULTS: Three factors were derived from the individual competences scale; 1) perceived competence of knowledge and skill, 2) ethic, and 3) qualification. And three factors were derived from the organizational competence scale; 1) teamwork, 2) network, and 3) followship.CONCLUSION: The PCS-DMHW demonstrated fairly high reliability and validity. Finally, the necessity of continuous validation study and the application modalities of this scale in education and training settings were discussed.

Erratum: Posttraumatic Stress Disorder Symptoms and Posttraumatic Growth Following Indirect Trauma from the Sewol Ferry Disaster, 2014

In the original publication, reference number 20 was incorrect.

Posttraumatic Stress Disorder Symptoms and Posttraumatic Growth Following Indirect Trauma from the Sewol Ferry Disaster, 2014

OBJECTIVE: The definition of psychological trauma, which was traditionally restricted to immediate and direct experience, is now expanding to include mediated or vicarious experience. So the present study aims to examine the relationship between the negative effects and the positive outcomes to a national disaster by assessing the posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth of the general public. METHODS: A nationwide survey of the Korean population (n=811) who were exposed to the Sewol ferry disaster through the media participated in this research, completing a self-report questionnaire consisting of demographic characteristics, Impact of Event Scale-Revised- Korean, and Korean-Stress-related Growth Scale-Revised. The participants were divided into three groups according to the severity of PTSD symptoms, then one-way ANOVA were conducted. RESULTS: The results revealed 30.4% of the sampled participants reported stress symptoms equivalent to partial or full PTSD. Posttraumatic growth was significantly higher in the full and the partial PTSD symptom groups when compared to the normal group [F (2, 759)=20.534, p < 0.001]. At a subscale level, mature thinking showed a more significant result [F (2,759)=23.146, p < 0.001] than religious growth [F (2, 180.984)=4.811, p < 0.01]. CONCLUSION: The results indicated a general linear trend between the severity of PTSD symptoms and posttraumatic growth level, suggesting that indirect trauma also induces both PTSD symptoms and posttraumatic growth like direct trauma does. The theoretical implications based on these findings were discussed.

Evidence-Based, Non-Pharmacological Treatment Guideline for Depression in Korea

Although pharmacological treatment constitutes the main therapeutic approach for depression, non-pharmacological treatments (self-care or psychotherapeutic approach) are usually regarded as more essential therapeutic approaches in clinical practice. However, there have been few clinical practice guidelines concerning self-care or psychotherapy in the management of depression. This study introduces the 'Evidence-Based, Non-Pharmacological Treatment Guideline for Depression in Korea.' For the first time, a guideline was developed for non-pharmacological treatments for Korean adults with mild-to-moderate depression. The guideline development process consisted of establishing several key questions related to non-pharmacologic treatments of depression, searching the literature for studies which answer these questions, assessing the evidence level of each selected study, drawing up draft recommendation, and peer review. The Scottish Intercollegiate Guidelines Network grading system was used to evaluate the quality of evidence. As a result of this process, the guideline recommends exercise therapy, bibliotherapy, cognitive behavior therapy, short-term psychodynamic supportive psychotherapy, and interpersonal psychotherapy as the non-pharmacological treatments for adult patients with mild-to-moderate depression in Korea. Hence, it is necessary to develop specific methodologies for several non-pharmacological treatment for Korean adults with depression.

Anti-Intrusion Effect of Lorazepam: An Experimental Study

OBJECTIVE: Easy triggering of trauma-related episodic memory fragments caused by perceptual cues is tied to strong perceptual priming in the implicit memory system. And among benzodiazepines, only lorazepam has been consistently reported to have an atypical suppression effect on perceptual priming processes. The aim of this study was to investigate the effects of single doses of lorazepam, diazepam, and a placebo on intrusive memories after exposure to a distressing videotape and to explore whether the anti-intrusive effect of lorazepam is acquired as a result of the suppression of perceptual but not conceptual priming processes. METHODS: Under prospective, randomized, and double-blind conditions, we compared the anti-intrusion effect of a single dose of lorazepam (n=22) with that of diazepam (n=22) and a placebo (n=21) in young healthy Korean college students following exposure to a traumatic videotape. RESULTS: We present the first finding for an anti-intrusion effect of lorazepam. One day after the medication, lorazepam, rather than diazepam or the placebo, significantly reduced the extent of intrusion and data-driven processing of the traumatic information. There were no differences among the three conditions in state anxiety, depression, and an arousal scale throughout the experiment. CONCLUSION: Results from this study suggest the possibility of lorazepam as a candidate anti-intrusion drug, as well as the cautious use of diazepam in the treatment of PTSD patients. The anti-intrusive effect of lorazepam is directly related to its atypical inhibitory effect on implicit perceptual priming processes. The present study provides support for the enhanced perceptual priming hypothesis of PTSD.

Factors Associated with Depressive Symptoms of the Married Women - Focused on Family Relationship Satisfaction and Conflict: Coping Method / 신경정신의학

OBJECTIVES: The purposes of this study were to investigate depressive symptoms among married women and to their understand depression through social and interpersonal factors. METHODS: The subjects were consisted of 632 married women who lived in 00 city. They completed the Beck Depression Inventory, Marital Global Distress Scale, Dissatisfaction with Children Scale, and Conflict-coping Method Scale. Descriptive statistics, correlation, chi2-test, ANOVA, step-wise regression, and hierarchical regression were applied to analyze the data. RESULTS: ANOVA analysis showed the differences in education, income, experience of abuse, parent-in-law relationship, marital global distress, dissatisfaction with children, rational coping, emotion/action-expression coping, and avoidant coping among the non-depressive group, mildly depressive group, and depressive group. Step-wise regression showed that the variance of the current depressive symptoms was accounted for by marital global distress, dissatisfaction with children, avoidance coping method, and satisfaction with parent-in-law (total account=36.1%). It was found that the rational coping method and avoidance coping method significantly mediated the relationship between the satisfaction with family relation and depressive symptoms. CONCLUSION: Therapeutic interventions for the married women experiencing depressive symptoms showed include their marital relationship. Based on the finding that the conflict coping methods mediated the association between the depressive symptoms and the family relation satisfaction, the effective conflict coping skills or social problem solving skills should be included in the interventions for married women.

The Psychological Characteristics of the Patients with Tension-Type Headache: Using MMPI

BACKGROUND: The investigations of personality traits have been the issue of many studies on patients with tension-type headache. However, there was few comparison study of personality traits between the patients with episodic tension-type headache (ETTH) and chronic tension-type headache (CTTH) using Minnesota Multiphasic Personality Inventory (MMPI). METHODS: The study was consecutively made of the personality profiles of two groups with ETTH (137 patients) and CTTH (115 patients) in accordance with the International Headache Society (IHS) criteria, employing the MMPI. RESULTS: The two groups could be classified into three clusters by a multivariate cluster analysis, which are relatively normal profile (cluster I), somatic profile (cluster II, elevated Hs-D-Hy scales), and psychosomatic profile (cluster III, elevated Pa-Pt-Sc-Si and Hs-D-Hy scales). The proportion of the patients with CTTH in the psychosomatic profile group was stastically more significant (59.6%) than that of the patients with ETTH (40.4%) by a chi-square test. CONCLUSIONS: This study shows that the psychosomatic profile might be more common in the CTTH patients than in the ETTH patients.

Initial Reliability and Validity of the Symptoms Questionnaire-Korean Version (SQ-K) / 신경정신의학

OBJECTIVE: Kellner (1987)'s Symptom Questionnaire (SQ) consists of 4 scales, i.e. depression, anxiety, anger-hostility, and somatic scales. The SQ can be administered and scored by a lay person with brief training. In addition to the use for the self-rating of distress in research, the SQ can be a checklist in clinical practice. The SQ has been validated in translations in Korean. This paper is to test the initial reliability and validity of the Symptom Questionnaire-Korean version (SQ-K). METHOD: The SQ-K and other self-report scales (i.e. BDI, STAI, STAXI, & SCL-90-R) were administered to college students (n=103) and psychiatric patients (n=170) including 76 with mood disorders, 47 with anxiety disorders, 27 with somatoform disorders, and 20 with Hwabyung patients. RESULTS: The test-retest coefficients of stability over a 2-week period ranged from .46 to .65 in a sample of college students. The SQ-K and subscales have good internal consistency, with an alpha ranged from .70 to .90. and good criterion-referenced validity. The SQ-K discriminated between college students with and without stress, psychiatric patients and college students, and among depressive, anxious, and Hwabyung groups. CONCLUSION: The SQ-K is a tool for state measurement, and it is quite sensitive to change. The findings suggest that the Korean translations are valid and sensitive scales of distress, and it can be used effectively in research and clinical practice as the original is.

Epidemiological Study of Geriatric Depression in a Korea Urban Area

OBJECTIVE: Depression in the elderly is a major health concern that can be life threatening if not recognized and treated. Despite considerable interest, there in no consensus regarding the prevalence of depression in later life. This study was aimed to investigate the prevalence of major depressive disorder in the population over age 65 years and provide fundamental data for community mental health programs. METHOD: 500 elderly people aged over 65 years and oner in Kwachon were interviewed according to DSM-IV and examined Geriatric Depression Scale(GDS), Korea Depression Scale(KDS), MMSE-K, Korea-Dementia Rating Scale(K-DRS), etc. by trained researchers. RESULTS: Of the sample, prevalence of mild, moderate and severe depressive symptoms are 18.8%, 7.4%, and 17.8%, respectively. Prevalence of major depressive disorder is found to be 7.8%. There is no significant differences between depressive & non-depressive groups in the sociodemographic variables such as sex, age, education, family type, etc. Major depressive disorder is associated with physical illness, stressful life events, and cognitive dysfunction. CONCLUSION: The results showed similar prevalence rates to other epidemiological studies. Depressed group showed more psychological distress, stressful life events and cognitive dysfunctions than non-depressed group. Accurate and early diagnosis and adequate treatment favor a good prognosis.

Epidemiological Study of Dementia in a Korea Urban Area

OBJECTIVE: Dementia is major neuropsychiatic disorder in the elderly. This study was aimed to investigate the prevalence of dementia and provide fundamental data for community mental health programs. METHOD: 500 elderly people aged 65 years and over in Kwachon were interviewed according to DSM-IV and examined MMSE-K, Korea-Dementia Rating Scale (K-DRS), Clinical Dementia Rating (CDR), Modified Hatchinski Ischemic Scale (MHIS) by trained research assistants. RESULTS: Prevalence of dementia is 10.6% (Alzheimer type 8.0%;vascular type 2.6%). Old age, lower education, cardiovascular disease, head trauma and heavy smoking seem to be risk factors for developing dementia but sex difference is non significant. CONCLUSION: The results showed similar prevalence rates compared to other epidemiological studies. Demented group showed more cognitive disturbances than non-demented one. For patients of dementia, appropriate treatment and management by family members, other caregivers and mental health professionals are needed.

The Knowledge and Practice of Sleep Hygiene in Residents of Seoul / 신경정신의학

PURPOSE: Poor sleep hygiene can complicate any other syndrome producing insomnia complaint and must always be considered in any treatment. In clinical situation, it is important for Insomniacs to practice the sleep hygiene rule in treatment strategies. The authors investigated the recognition of sleep hygiene and the practice of it in general population, then provided the data available for physician to educate the sleep hygiene in treatment of insomnia. METHOD: The 330 subjects were at the age above 18 in Seoul, Korea. The questionnaire included the experience of insomnia and knowledge of caffeine, and 4 categories of sleep hygiene instruction, eg, homeostatic drive far sleep, circadian factors, drug effects, and arousal in sleep sleeper. The interview was done face to face by the investigators. RESULTS: In general, the knowledge about the drug effects on sleep was relatively poor. The degree of recognition of each item indicating organization of sleep and arousal in sleep setting was various. Poor sleeper showed no difference in recognition of sleep hygiene categories except drug effects on sleep compared to good sleeper, but they practiced sleep hygiene rules poorly in categories of homeostatic drive and arousal in sleep setting, though various by items. CONCLUSION: The findings, in which the degree of recognition of the items in 4 sleep hygiene categories was venous, indicated that sleep hygiene education should be done in details by each item. It seems like the poor sleeper practiced sleep hygiene poorly in categories of homeostatic drive and arousal in sleep setting compared to good sleeper. this finding suggested that the efforts, which reflected the behavioral patterns of insomniacs shown in clinical setting to get good sleep, frustrated the practice of sleep hygiene actively.

The Relationship of Coping Style and Psychological Distress in the Survivors of Sampoong Accident / 신경정신의학

Although the same traumatic stress was experienced, the presenting symptoms and their severity might be different. The difference could be associated with the coping style. Thus we were interested in which coping style is more efficient in dealing with stress. Among the 624 survivors of Sampoong Accident we selected active coping group(n=67) and passive coping group(n=63) using the Ways of Coping Checklist. These two groups were compared on scores in Beck Depression Inventory, State-Trait Anxiety Inventory, Impact of Event Scale, MMPI, and 16 Personality Factor Questionnaire. The passive coping group reported that they were more anxious and depressive, and they showed more intrusive thought about traumatic stress, denial, and vulnerable factors of personality than active coping group. These results suggest that active coping style such as problem-focused coping and seeking social supports is more efficient and successful in case as Sampoong Accident. Therefore, for the survivors of extremely traumatic accident, training of active coping skills can be helpful for rehabilitation and adaptation in everyday life.