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Objective@#The purpose of the present study was to develop and validate the Korean version of the clinician-administered KSADSCOMP, which is the recently updated, web-based computerized version of the Kiddie Schedule for Affective Disorders and Schizophrenia for school-age children (KSADS). @*Methods@#A total of 71 participants (mean age=12.04±3.86 years, female=29.57%) participated in the study. A child-adolescent psychiatrist established a diagnosis for the participant after a thorough psychiatric interview with the participant and the parent. Researchers who were blind to the diagnoses administered the clinician-administered KSADS-COMP to the parents and participants. The gold-standard diagnoses made by child-adolescent psychiatrists were compared to the current diagnoses generated by the clinician-administered KSADS-COMP. Percent agreement, Cohen’s Kappa, Gwet’s first-order agreement coefficient (AC1), sensitivity, specificity, positive predictive value, and negative predictive value were calculated. @*Results@#Gwet’s AC1, our preferred measure of agreement, showed excellent range between 0.78 and 1. Sensitivity, specificity, positive predicted value and negative predictive value also showed high scores. @*Conclusion@#The current study demonstrated excellent criterion validity of the Korean version of the clinician-administered KSADSCOMP, though the small sample size could be a limitation. The current study was the first study to examine the criterion validity of the KSADS-COMP. Due to its readily usable format and efficient and accurate diagnostic process, widely-use of KSADS-COMP is expected.
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Objectives@#The coronavirus disease 2019 (COVID-19) pandemic has led to a decrease in face-to-face classes worldwide, affecting the mental health of children and their parents. The global pandemic has increased children’s overall use of electronic media. This study analyzed the effect of children’s screen time on problematic behaviors during the COVID-19 pandemic. @*Methods@#A total of 186 parents from Suwon, South Korea, were recruited to participate in an online survey. The mean age of the children was 10.14 years old, and 44.1% were females. The questionnaire included questions on children’s screen time, problematic behaviors, and parental stress. Children’s behavioral problems were evaluated using the Behavior Problem Index, whereas the Parental Stress Scale was used to estimate parental stress. @*Results@#The mean smartphone usage frequency of the children was 5.35 days per week, and the mean smartphone screen time was 3.52 hours per day. Smartphone screen time (Z=4.49, p<0.001) and usage frequency (Z=2.75, p=0.006) were significantly correlated with children’s behavioral problem scores. The indirect effect of parental stress on this relationship was also statistically significant (p=0.049, p=0.045, respectively). @*Conclusion@#This study suggests that children’s smartphone screen time has affected problematic behaviors during the COVID-19 pandemic. Furthermore, parental stress is related to the relationship between children’s screen time and problematic behaviors.
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Background@#As the coronavirus disease 2019 (COVID-19) has continued for a couple of years, the long-term effects of the pandemic and the subsequent school curriculum modification on the mental health of children and parents need to be investigated. To clarify the changes that can occur during one school year and to predict the risk factors for vulnerable groups, this study identified parameters relative to children’s screen time, their problematic behavior, and parental depression. @*Methods@#A total of 186 participants were analyzed who were parents of elementary schoolchildren in South Korea. These parents were required to complete a web-based questionnaire twice. The questionnaires were conducted in June 2020 and September 2021. Participants’ general demographics including family income, children’s screen time, sleep patterns, problematic behavior, and parental depression were assessed via the parental questionnaire that included various measurement tools. @*Results@#Children’s body mass index (BMI) increased significantly in 2021 (18.94 ± 3.75 vs. 18.14 ± 3.30, P < 0.001). Smartphone frequency of use per week (5.35 vs. 4.54, P < 0.001) and screen time per day (3.52 vs. 3.16, P < 0.001) significantly increased during the period of the COVID-19 pandemic. The television screen time (2.88 vs. 3.26, P < 0.001), frequency of viewing (3.77 vs. 4.77, P < 0.001), and children’s problematic behaviors significantly decreased (9.15 vs. 11.85,P < 0.001). A lower income household was a key predictor of increased smartphone frequency (B = 1.840, 95% confidence interval [CI], 0.923–2.757, P < 0.001) and smartphone screen time (B = 1.992, 95% CI, 1.458–2.525, P < 0.001). The results showed that the lower income household (B = 5.624, 95% CI, 2.927–8.320, P < 0.001) and a child’s psychiatric treatment history (B = 7.579, 95% CI, 5.666–9.492, P < 0.001) was the most significant predictor of problematic behaviors of children and parental depression (B = 3.476, 95% CI, 1.628–5.325, P < 0.001; B = 3.138, 95% CI, 1.827–4.450, P < 0.001). @*Conclusion@#This study suggested that children’s smartphone screen time and BMI increased during COVID-19 because of the school curriculum modification following school closures in South Korea. The increased children’s problematic behaviors and parental depression were predicted by lower-income households and the previous psychiatric history of children. These results indicate that multiple social support systems to the vulnerable group are needed during the ongoing pandemic and that a modified school setting is required.
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Objectives@#This study identified the association between excessive exposure to screen media and behavioral and emotional problems in elementary school students. @*Methods@#A total of 331 parents of children aged 7–10 years were recruited from “The Kids Cohort for Understanding of Internet Addiction Risk Factors in Early Childhood (K-CURE)” study. Children’s demographics, household media ownership, screen time, and behavioral/emotional problems were assessed using a parental questionnaire. Children’s behavior/emotional problems were measured using the Korean version the of Child Behavior Checklist (K-CBCL) score. @*Results@#The total K-CBCL score in the screen overuse group was 51.18±9.55, significantly higher than 47.28±10.09 in the control group (t=2.14, p=0.05). For each subscale, the externalization score (51.65±10.14, 48.33±8.97, respectively; t=2.02, p<0.05), social problem score (55.41±6.11, 53.24±5.19, respectively; t=2.27, p<0.05), and rule breaking behavior score (55.71±6.11, 53.24±5.19, respectively; t=2.27, p<0.05) were significantly higher in the screen overuse group than in the control group. In addition, the screen overuse group also had a significantly higher usage rate than the control group, even if limited to smartphones, not only on weekdays (3.56±2.08, 1.87±2.02, respectively; t=-4.597, p<0.001) but also weekends (1.62±0.74, 1.19±0.83, respectively; t=-3.14, p=0.003). @*Conclusion@#The study suggested that screen media overuse patterns in children in Korea are particularly relevant to the excessive use of smartphones and are related to higher risks of emotional and behavioral problems.
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Objectives@#This study determines the effects of comorbidity of mood disorder and alcohol use disorder on suicide behavior. @*Methods@#We converted data from the electronic medical records of one university hospital into a common data model and utilized it in our analysis. We selected 9551 patients with diagnosis codes of mood disorders or alcohol use disorders and divided them into three groups: mood disorder (MD) only, alcohol use disorder (AUD) only, and comorbidity of mood disorder and alcohol use disorder (MD+AUD). The mood disorder group was also subgrouped with depressive (DD) or bipolar affective disorder (BD) groups, and the comorbidity group was classified in the same way. Then, we applied logistic regression analysis to assess the risk of suicide attempts between the diagnostic groups. Subgroup analysis according to age also was conducted. @*Results@#The MD+AUD group had 2.7 (odd ratio [OR]=2.70, 95% confidence intervals [CI]=1.91– 3.81, p<0.0001) and the DD+AUD group had 2.78 (OR=2.78, 95% CI=1.95–3.98, p<0.0001) times higher risk of suicide attempts than the MD only and DD only group, respectively. Furthermore, according to the age subgroup, the risk of suicide attempts was the highest (OR=5.17, 95% CI=2.35–11.40, p<0.0001) in the DD+AUD group for those aged 40–59. There were no significant results in BD. @*Conclusion@#The results showed that the comorbidity of mood disorder and alcohol use disorder could increase suicide risk. This study suggested that alcohol use behavior needs to be assessed as well as mood symptoms for suicide prevention.
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Background@#Coronavirus disease 2019 (COVID-19) is different from previous disasters in that it continues to the present and has affected all aspects of family life. During epidemics, psychosocial support is not less important than infection control. During COVID-19-related school closures, prolonged partial closures of schools could have detrimental social and health consequences for children and may increase the burden on the family. Based on a community sample in Korea, this study identified parental concerns, children's media usage, other various factors and examined whether parental stress level or depression were positively associated with problem behaviors, media exposure, and sleep problems of the primary school children during school closure under COVID-19. @*Methods@#Participants were 217 parents residing in Suwon, South Korea, who had primary school children and responded to a web-based questionnaire on parental concerns from school closure under COVID-19, subjective stress, depression, whether having received mental health services, and family characteristics; children's sleep patterns, problem behaviors, media usage during the online-only class period, and changes in activity level following the pandemic. @*Results@#During school closure, children gained body weight, spent less time in physical activities and more in media usage. Besides online learning content (97.2%), YouTube was highly used content (87.6%), and games followed (78.3%). Parental subjective stress index was highly associated with parental depression (Pearson correlation 0.439, P < 0.001), children's sleep problems (0.283, P < 0.001), tablet time (0.171, P = 0.012) and behavior problems (0.413, P < 0.001). Parental depression was associated with children's sleep problems (0.355, P < 0.001), TV time (0.153, P = 0.024), tablet time (0.159, P = 0.019), and behavior problems (0.524, P < 0.001). Parents who previously received mental services seemed to be more concerned about the problems their children already have getting worse because of COVID-19 than the disease itself. Children's sleep problem was associated with tablet (0.172, P = 0.011) and smartphone time (0.298, P < 0.001), but not its frequency. @*Conclusion@#During COVID-19-related school closures, many parents and children had various difficulties relating to mental health. Ongoing monitoring of mental health of highrisk groups and multiple support systems may need to be expanded to cover those parents having difficulty in caring for their children.
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Objectives@#This study identified the association between excessive exposure to screen media and behavioral and emotional problems in elementary school students. @*Methods@#A total of 331 parents of children aged 7–10 years were recruited from “The Kids Cohort for Understanding of Internet Addiction Risk Factors in Early Childhood (K-CURE)” study. Children’s demographics, household media ownership, screen time, and behavioral/emotional problems were assessed using a parental questionnaire. Children’s behavior/emotional problems were measured using the Korean version the of Child Behavior Checklist (K-CBCL) score. @*Results@#The total K-CBCL score in the screen overuse group was 51.18±9.55, significantly higher than 47.28±10.09 in the control group (t=2.14, p=0.05). For each subscale, the externalization score (51.65±10.14, 48.33±8.97, respectively; t=2.02, p<0.05), social problem score (55.41±6.11, 53.24±5.19, respectively; t=2.27, p<0.05), and rule breaking behavior score (55.71±6.11, 53.24±5.19, respectively; t=2.27, p<0.05) were significantly higher in the screen overuse group than in the control group. In addition, the screen overuse group also had a significantly higher usage rate than the control group, even if limited to smartphones, not only on weekdays (3.56±2.08, 1.87±2.02, respectively; t=-4.597, p<0.001) but also weekends (1.62±0.74, 1.19±0.83, respectively; t=-3.14, p=0.003). @*Conclusion@#The study suggested that screen media overuse patterns in children in Korea are particularly relevant to the excessive use of smartphones and are related to higher risks of emotional and behavioral problems.
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Objectives@#This study determines the effects of comorbidity of mood disorder and alcohol use disorder on suicide behavior. @*Methods@#We converted data from the electronic medical records of one university hospital into a common data model and utilized it in our analysis. We selected 9551 patients with diagnosis codes of mood disorders or alcohol use disorders and divided them into three groups: mood disorder (MD) only, alcohol use disorder (AUD) only, and comorbidity of mood disorder and alcohol use disorder (MD+AUD). The mood disorder group was also subgrouped with depressive (DD) or bipolar affective disorder (BD) groups, and the comorbidity group was classified in the same way. Then, we applied logistic regression analysis to assess the risk of suicide attempts between the diagnostic groups. Subgroup analysis according to age also was conducted. @*Results@#The MD+AUD group had 2.7 (odd ratio [OR]=2.70, 95% confidence intervals [CI]=1.91– 3.81, p<0.0001) and the DD+AUD group had 2.78 (OR=2.78, 95% CI=1.95–3.98, p<0.0001) times higher risk of suicide attempts than the MD only and DD only group, respectively. Furthermore, according to the age subgroup, the risk of suicide attempts was the highest (OR=5.17, 95% CI=2.35–11.40, p<0.0001) in the DD+AUD group for those aged 40–59. There were no significant results in BD. @*Conclusion@#The results showed that the comorbidity of mood disorder and alcohol use disorder could increase suicide risk. This study suggested that alcohol use behavior needs to be assessed as well as mood symptoms for suicide prevention.
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Background@#Coronavirus disease 2019 (COVID-19) is different from previous disasters in that it continues to the present and has affected all aspects of family life. During epidemics, psychosocial support is not less important than infection control. During COVID-19-related school closures, prolonged partial closures of schools could have detrimental social and health consequences for children and may increase the burden on the family. Based on a community sample in Korea, this study identified parental concerns, children's media usage, other various factors and examined whether parental stress level or depression were positively associated with problem behaviors, media exposure, and sleep problems of the primary school children during school closure under COVID-19. @*Methods@#Participants were 217 parents residing in Suwon, South Korea, who had primary school children and responded to a web-based questionnaire on parental concerns from school closure under COVID-19, subjective stress, depression, whether having received mental health services, and family characteristics; children's sleep patterns, problem behaviors, media usage during the online-only class period, and changes in activity level following the pandemic. @*Results@#During school closure, children gained body weight, spent less time in physical activities and more in media usage. Besides online learning content (97.2%), YouTube was highly used content (87.6%), and games followed (78.3%). Parental subjective stress index was highly associated with parental depression (Pearson correlation 0.439, P < 0.001), children's sleep problems (0.283, P < 0.001), tablet time (0.171, P = 0.012) and behavior problems (0.413, P < 0.001). Parental depression was associated with children's sleep problems (0.355, P < 0.001), TV time (0.153, P = 0.024), tablet time (0.159, P = 0.019), and behavior problems (0.524, P < 0.001). Parents who previously received mental services seemed to be more concerned about the problems their children already have getting worse because of COVID-19 than the disease itself. Children's sleep problem was associated with tablet (0.172, P = 0.011) and smartphone time (0.298, P < 0.001), but not its frequency. @*Conclusion@#During COVID-19-related school closures, many parents and children had various difficulties relating to mental health. Ongoing monitoring of mental health of highrisk groups and multiple support systems may need to be expanded to cover those parents having difficulty in caring for their children.
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Objective@#As smartphone use is becoming more common, the age of initial exposure to devices is becoming younger. Young children’s screen use is influenced by various factors; it is more directly dependent on family environment than school-aged children. Our study aimed to examine the effect of mother’s smartphone addition on their child’s smartphone use. @*Methods@#Participants were from the Kids Cohort for Understanding of internet addiction Risk factors in early childhood (K-CURE) study. Adult smartphone addiction self-diagnosis scale was used to evaluate smartphone addiction degree of mother. Child’s smartphone use was assessed by parental questionnaire. Using logistic regression analysis, we examine the association between mother’s smartphone addiction and child’s smartphone use. @*Results@#After adjusting for other factors, mother’s smartphone addiction is related with early smartphone exposure of children. Highrisk group’s children was exposed to smartphone earlier than low risk group (adjusted OR, 0.418; p=0.021). Contrary to expectation, there is no correlation between mother’s smartphone addiction and child’s smartphone use time. @*Conclusion@#Our study explain that mother’s smartphone addiction can affect early smartphone exposure on children. Based on our findings, further study might explore the effect of early smartphone exposure on children.
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Objective@#Early detection and proper management of mental illness can help to prevent severe deterioration. However, with limited financial and human resources of community mental health services, it is not practical to carry out all conventional screening tools simultaneously. In this study, we aimed to develop and validate a brief but comprehensive screening questionnaire for four common mental illnesses of the elderly. @*Methods@#The brief screening for four mental illnesses of elderly (BS4MI-elderly) is a 14-item binary response questionnaire that covers dementia, depressive disorder, sleep disorder, and hwa-byung. To test validity, we compared conventional scale scores for three groups of participants classified using the BS4MI-elderly. The sensitivity, specificity, predictive value of positive test, likelihood ratio of positive test and internal consistency of the BS4MI-elderly were assessed. Finally, a correlation analysis between the BS4MI-elderly and general mental health scales was conducted. @*Results@#A total of 254 participants aged over 65 years were recruited. The BS4MI-elderly showed moderate to high sensitivity for the test that distinguishes the normal group from the risk and disorder groups (dementia: 0.61, depressive disorder: 0.88, sleep disorder: 0.85, hwa-byung: 0.94) and high specificity for the test that distinguishes the disorder group from the normal and risk groups (dementia: 0.91, depressive disorder: 0.93, hwa-byung: 0.84, sleep disorder: 0.84). The BS4MI-elderly also exhibited good internal consistency and significant correlations with general mental health scales. @*Conclusion@#The BS4MI-elderly, a brief but comprehensive screening tool, could be a useful instrument for screening the elderly in community mental health services.
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BACKGROUND: Children today are exposed to various media devices, and their usage of these is increasing. Prior studies have outlined forms of harm this can potentially cause. However, there has been little empirical research on the use of media devices among preschool children in Asia. The aim of this study was to examine and analyze longitudinal trends in media device use among Korean preschool children, focusing on the frequency of engagement, time spent with, and ownership of media devices, delineated by sex. METHODS: Four hundred parents of children aged 2–5 years were invited to enroll. The baseline assessment, Wave 1, was conducted between December 2015 and June 2016, and follow-up assessments, Wave 2 and Wave 3, were conducted annually for the following 2 years. Time of media use, frequency of media use, and ownership of media devices (TV, tablet PCs, and smartphones) were investigated. RESULTS: Ownership of tablet PCs increased significantly between Wave 1 and Wave 3 for boys and girls (corrected P < 0.001). Frequency of media use increased significantly between Wave 1 and Wave 3 only in boys' use of tablet PCs (mean difference 0.8 day/wk). Time of media use increased significantly between Wave 1 and Wave 3 for both sexes in all devices, measured by mean difference on weekdays and weekends (TV by 0.6 and 0.7 hr/day, tablet PCs by 0.6 and 0.8 hr/day, and smartphones by 0.4 and 0.4 hr/day). Children spent more time using media devices during weekends than on weekdays. CONCLUSION: This study observed an increase in the tendency of media device use among preschool children in Korea. The patterns of use indicate that paying attention to the types of devices children use is needed, as well as vigilance on weekends.
Subject(s)
Child , Child, Preschool , Female , Humans , Asia , Empirical Research , Follow-Up Studies , Korea , Ownership , Parents , SmartphoneABSTRACT
“Comfort women” are survivors of sexual slavery by the Imperial Japanese Army during World War II, who endured extensive trauma including massive rape and physical torture. While previous studies have been focused on the trauma of the survivors themselves, the effects of the trauma on the offspring has never been evaluated before. In this article, we reviewed the first study on the offspring of former “comfort women” and aimed to detect the evidence of transgenerational transmission of trauma. In-depth psychiatric interviews and the Structured Clinical Interview for DSM-5 Axis I Disorders were conducted with six offspring of former “comfort women.” Among the six participants, five suffered from at least one psychiatric disorder including major depressive disorder, panic disorder, posttraumatic stress disorder, adjustment disorder, insomnia disorder, somatic symptom disorder, and alcohol use disorder. Participants showed similar shame and hyperarousal symptoms as their mothers regarding stimuli related to the “comfort woman” issue. Increased irritability, problems with aggression control, negative worldview, and low self-esteem were evident in the children of mothers with posttraumatic stress disorder. Finding evidence of transgenerational transmission of trauma in offspring of “comfort women” is important. Future studies should include more samples and adopt a more objective method.
Subject(s)
Child , Humans , Adjustment Disorders , Aggression , Asian People , Depressive Disorder, Major , Methods , Military Personnel , Mothers , Panic Disorder , Rape , Shame , Enslavement , Sleep Initiation and Maintenance Disorders , Stress Disorders, Post-Traumatic , Survivors , Torture , World War IIABSTRACT
BACKGROUND: It is known that there are various factors associated with children's screen overuse. The aim of this study was to examine the effect of maternal depression on 2–5-year-old children's overuse of various household screen devices. METHODS: Participants were from the Internet-Cohort for Understanding of internet addiction Risk factors/Rescue in Early livelihood (I-CURE) study, an observational prospective cohort study in Korea. Screen time for six types of screen devices (smartphone, television, computer, tablet, video gaming console, and portable gaming console) were assessed by parental questionnaire. Maternal depression was measured by the Korean version of the Beck Depression Inventory II. Logistic regression models were run to determine the association between maternal depression and children's screen overuse. RESULTS: Maternal depression was associated with children's television overuse after adjusting for other factors (odds ratio, 1.954; P = 0.034). Contrary to expectation, the relationship between maternal depression and screen time was not present on other devices such as smartphones, computers and tablets. CONCLUSION: Maternal depression is related with 2–5-year-old children's television overuse. Interventions in maternal depressive symptoms and the associated changes in parent-child relationship can be useful for preventing children's television overuse.
Subject(s)
Humans , Cohort Studies , Computers, Handheld , Depression , Family Characteristics , Internet , Korea , Logistic Models , Parent-Child Relations , Parents , Prospective Studies , Smartphone , Tablets , TelevisionABSTRACT
OBJECTIVE: These days, young children are exposed to a wide range of smart devices and their usage of smart devices is rapidly increasing worldwide. However, the use of smart devices by young children has not been studied in detail yet because smart device is relatively recent. The purpose of this study was to investigate the exposure status of smart devices among 2–5 years old children in Korea. METHODS: Four hundred parents of 2- to 5-year-old children were invited to enroll. Data on demographic information and the frequency of media use, time of media use, age at first use of media was self-reported. RESULTS: Among 390 toddlers, 39.3% watched TV almost every day, while 12.0% of children used smartphone on a daily basis. During weekdays, 48% of the children watched TV for over an hour. On weekends, 63.1% of the children watched TV for over an hour. On weekends, 23.4% of children use their smartphones for over an hour. Children using smartphones before 24 months of age were 31.3%. CONCLUSION: Research has shown that TV and smartphones are the most popular digital devices used by toddlers. Most toddlers began using smart devices at 12–24 months. This study provides comprehensive information on children’s contemporary use of media.
Subject(s)
Child , Child, Preschool , Humans , Korea , Parents , SmartphoneABSTRACT
“Comfort women” refers to young women and girls who were forced into sexual slavery by the Imperial Japanese military during World War II. They were abducted from their homes in countries under Imperial Japanese rule, mostly from Korea, and the rest from China, Philippines, Malaysia, Taiwan, Indonesia, the Netherlands, etc. “Comfort women” endured extreme trauma involving rape, sexual torture, physical abuse, starvation, threats of death, and witnessed many others being tortured and killed. This article reviews all the studies that have investigated the psychiatric or psychosocial sequelae of the survivors of the Japanese military sexual slavery. Most importantly, a recent study which conducted a psychiatric evaluation on the former “comfort women” currently alive in South Korea is introduced. The participants’ unmarried rate was relatively high and their total fertility rate was relatively low. Majority of the participants reported having no education and being the low economic status. They showed high current and lifetime prevalence of posttraumatic disorder, major depressive disorder, somatic symptom disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Participants showed high suicidality and majority of the participants still reported being ashamed of being former “comfort women” after all these years. This article high-lights the fact that the trauma has affected the mental health and social functioning of former “comfort women” throughout their lives, and even to the present day.