The Relationship among Psychopathology, Cognitive Function, Insight and Quality of Life in Elderly Patients with Chronic Schizophrenia

OBJECTIVE: The aim of this study was to investigate the association with psychopathology, cognitive function, insight and quality of life (QOL) in elderly patients with chronic schizophrenia over age 55. METHODS: 103 schizophrenic patients over age 55 with illness duration over 10 years, are enrolled in a cross-sectional study. The subjects were assessed by the Korean version of 4th Revision of Schizophrenia Quality of Life Scale, Korean Version of Scales to Assessment Unawareness of Mental Disorder, Positive and Negative Syndrome Scale (PANSS) and the cognitive function battery designed for this study. Multiple regression stepwise selection models were executed to identify the relations among variables, and the contributing factors to QOL. RESULTS: Among schizophrenic patients with lower illness-severity with PANSS total score below 75, higher PANSS positive subscale score and lower number of hospitalization were related to lower QOL. Among patients with higher illness-severity with PANSS total score of 75 and over, higher PANSS general psychopathology subscale score, better intelligence, better delayed recall function, worse attention, better awareness of medication effect and later onset were related to lower QOL. CONCLUSION: Results of our study suggest that improvement in positive symptom and general psychopathology could increase the QOL in elderly patients with chronic schizophrenia over age 55. And the management which could improve attention, awareness of need for medication would attribute the QOL.

Activation Plans for Psychiatric Research / 신경정신의학

OBJECTIVES: Dealing with mental diseases is an overriding concern which could bring about improvement in mental health, social equity, and quality of life. This paper analyzes the current state of research infrastructure of national mental health research in Korea and other developed countries and suggests activation plans for psychiatric research. METHODS: After performance of comparative analysis, shortcomings of Korean infrastructure are examined and activation plans are suggested. RESULTS: Korea is comparatively and absolutely lagging behind in terms of mental health Research and Development (R&D), owing to the small investment in R&D, inadequate government-led long-term developmental strategy and supporting system, absence of industrialization of developed techniques and government-led R&D project, and insufficient human resources, which impedes facilitation of mental health research. Thus, in order to facilitate mental health research, 1) Reinforce international cooperation and research capability through cultivation of professionals equipped with international competitiveness. 2) Construct a government-led R&D system by establishment of a comprehensive R&D system and mental health research institutes. 3) Build cooperative systems between industry and academic circles and promote translational research and its practical use in order to lay the cornerstone for industrialization. CONCLUSION: Developed countries have achieved significant growth and superb investment performance in the mental health industry due to constant and active investment by government. In addition, basic-clinical-mental health research regarding early diagnosis, early intervention, and tailored treatment, is actively being put into practice. In Korea, government-led long-term investment plans in psychiatric research and researcher cultivation programs should be implemented. In addition, infrastructure for application of developed techniques should also be established. If so, it will provide momentum for growth and facilitation of psychiatric research.

Development of Mental Health Indicators in Korea

OBJECTIVE: Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea. METHODS: This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries. RESULTS: We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders. CONCLUSION: Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation.