Long Term Follow-Up of Metabolic Syndrome in Patients with Severe Mental Illness among Korean Population : A 10-Year Follow-Up Study (2011-2020) / 생물치료정신의학

Objectives@#：This study was aimed to investigate the changes in metabolic syndrome (MetS) status and long-term impact of its components over a 10-year period in severe mental illness (SMI) patients in a national mental hospital. @*Methods@#：A total of 93 patients (schizophrenia=88, bipolar disorder=5) who met the diagnosis of Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) and participated in the MetS study in 2011 were included. MetS was defined by revised National Cholesterol Education Program-Adult Treatment Panel III (revised NCEP-ATP-III) guidelines. @*Results@#：The prevalence of MetS was significantly increased from 40.9% in 2011 to 60.2% in 2020. There were significant differences in admission status and hospitalization months, compared to the groups with and without MetS. Upon reviewing the changes over a decade, systolic blood pressure (SBP) was a significant factor in the group without MetS. In the group with MetS, SBP, waist circumference, and BMI (body mass index) were significant factors. Multiple logistic regression analysis revealed that hospitalization during follow-up periods [odds ratio (OR)=0.969, 95% confidence interval (CI): 0.948-0.991] and BMI (OR=1.426, 95% CI: 1.196-1.701) were significantly associated with MetS in subjects. @*Conclusion@#：The prevalence of MetS in patients with SMI significantly increased over time. The admission status and hospitalization were also confirmed to be the significant values of MetS.

Factors Associated with Resilience in School-Aged Adolescents / 생물치료정신의학

Objectives@#：The aim of this study was to examine socio-demographic variables and the correlation of their factors and mental health with resilience in adolescents. @*Methods@#：Participants were 4,325 middle and high school students living in Jeollanam-do, South Korea. Participants completed self-report questionnaires examining socio-demographic characteristics and including the following self-rating scales: the resilience test, the adolescent mental health and problem behavior screening questionnaire-II (AMPQ-II). @*Results@#：The resilience test scores were positively correlated with the adolescent mental health and problem behavior screening questionnaire-II scores (p<0.001). In multiple regression analysis, below average academic achievement (OR 4.05, 95%CI 2.62-6.27, p<0.001), perceived poor relationship with parents (OR 2.91, 95%CI 2.28-3.71, p<0.001), body dissatisfaction (OR 2.09, 95%CI 1.57-2.79, p<0.001), middle school students (OR 2.02, 95%CI 1.59-2.56, p<0.001), male (OR 1.95, 95%CI 1.55-2.46, p<0.001), low socioeconomic status (OR 1.68, 95%CI 1.11-2.52, p=0.014), low maternal education level (OR 1.64, 95%CI 1.09-2.48, p=0.018) showed significant negative correlation with resilience. @*Conclusion@#：Resilience needs to be considered to promote mental health of adolescents. Specifically, interventions providing psychological support should target adolescents with factors correlated low resilience

Actigraphic Measurement of Sleep Quality and Physical Activity of Schizophrenic Inpatients with Metabolic Syndrome / 생물치료정신의학

Objectives@#：The authors examined the association of sleep quality and metabolic syndrome (MetS) in schizophrenic patients using actigraphy. @*Methods@#：A total of 101 schizophrenic patients were included in this study. Fifty-four (53.4%) patients met the criteria of MetS. Self-assessment of subjective sleep quality, daytime sleepiness, physical activities were measured using Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and International Physical Activity Questionnaire (IPAQ), respectively. Objective sleep quality and physical activity were measured by Actigraph (ActiGraph wGT3X-BT). @*Results@#：Total time in bed (TIB) (p=0.032), sleep latency (SL) (p=0.001), wake after sleep onset (WASO) (p<0.001) and average awakening (p=0.015) were significantly longer in patients with MetS than those of non-MetS. Results of multiple logistic regression showed that long sleep latency (OR 7.876, 95% CI 1.519, p=0.014) and low sleep efficiency (OR 9.902, 95% CI 1.111, p=0.040) were high risk factors for MetS. @*Conclusion@#：This was the first study to find the correlations of sleep quality and MetS in schizophrenic patients by objective sleep measurements. Although long sleep latency and low sleep efficiency were associated with MetS in patients with schizophrenia, more extensive and complicated designed studies may be needed to the association of MetS and sleep problems in schizophrenic patients.

Factors Associated with Resilience in School-Aged Adolescents / 생물치료정신의학

Objectives@#：The aim of this study was to examine socio-demographic variables and the correlation of their factors and mental health with resilience in adolescents. @*Methods@#：Participants were 4,325 middle and high school students living in Jeollanam-do, South Korea. Participants completed self-report questionnaires examining socio-demographic characteristics and including the following self-rating scales: the resilience test, the adolescent mental health and problem behavior screening questionnaire-II (AMPQ-II). @*Results@#：The resilience test scores were positively correlated with the adolescent mental health and problem behavior screening questionnaire-II scores (p<0.001). In multiple regression analysis, below average academic achievement (OR 4.05, 95%CI 2.62-6.27, p<0.001), perceived poor relationship with parents (OR 2.91, 95%CI 2.28-3.71, p<0.001), body dissatisfaction (OR 2.09, 95%CI 1.57-2.79, p<0.001), middle school students (OR 2.02, 95%CI 1.59-2.56, p<0.001), male (OR 1.95, 95%CI 1.55-2.46, p<0.001), low socioeconomic status (OR 1.68, 95%CI 1.11-2.52, p=0.014), low maternal education level (OR 1.64, 95%CI 1.09-2.48, p=0.018) showed significant negative correlation with resilience. @*Conclusion@#：Resilience needs to be considered to promote mental health of adolescents. Specifically, interventions providing psychological support should target adolescents with factors correlated low resilience

Actigraphic Measurement of Sleep Quality and Physical Activity of Schizophrenic Inpatients with Metabolic Syndrome / 생물치료정신의학

Objectives@#：The authors examined the association of sleep quality and metabolic syndrome (MetS) in schizophrenic patients using actigraphy. @*Methods@#：A total of 101 schizophrenic patients were included in this study. Fifty-four (53.4%) patients met the criteria of MetS. Self-assessment of subjective sleep quality, daytime sleepiness, physical activities were measured using Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and International Physical Activity Questionnaire (IPAQ), respectively. Objective sleep quality and physical activity were measured by Actigraph (ActiGraph wGT3X-BT). @*Results@#：Total time in bed (TIB) (p=0.032), sleep latency (SL) (p=0.001), wake after sleep onset (WASO) (p<0.001) and average awakening (p=0.015) were significantly longer in patients with MetS than those of non-MetS. Results of multiple logistic regression showed that long sleep latency (OR 7.876, 95% CI 1.519, p=0.014) and low sleep efficiency (OR 9.902, 95% CI 1.111, p=0.040) were high risk factors for MetS. @*Conclusion@#：This was the first study to find the correlations of sleep quality and MetS in schizophrenic patients by objective sleep measurements. Although long sleep latency and low sleep efficiency were associated with MetS in patients with schizophrenia, more extensive and complicated designed studies may be needed to the association of MetS and sleep problems in schizophrenic patients.

Screening for Attention Deficit Hyperactivity Disorder among Korean College Students: Prevalence, Correlates and Comorbidities / 우울ㆍ조울병

BACKGROUND: The aim of this study was to screen Korean college students for correlates, and comorbidities associated with attention-deficit hyperactivity disorder (ADHD).METHODS: A total of 2,593 college students participated in the study. Socio-demographic and clinical data were collected and self-report scales, such as the Adult ADHD Self-Report Scale-Version 1.1, the Center for Epidemiologic Studies Depression Scale, the Korean version of the Mood Disorder, a modified Korean version of the 16-item Prodromal Questionnaire, and the Alcohol Use Disorders Identification Test were included. Students with and without ADHD were compared using univariable analyses, and the association of ADHD with other psychiatric comorbidities was predicted using multivariable analyses.RESULTS: Of the total participants, 4.7% were diagnosed with ADHD. Multivariable analysis revealed that ADHD in college students was significantly associated with depression, psychotic-like experience, alcohol abuse, and female sex after adjustment. We found that ADHD in young college students was associated with several psychiatric comorbidities.CONCLUSION: These results suggest the need for early detection of ADHD in young adults and highlight the importance of implementing early psychiatric intervention for problems such as depression, psychotic-like experience, and alcohol abuse in adults with ADHD.

Association of Mental Health Status with Suicidal Ideation among the Community-Dwelling Elderly / 우울ㆍ조울병

BACKGROUND: This study examined how mental health status influenced suicidal ideation among community-dwelling elderly at senior citizen centers in Korea.METHODS: Data were obtained from a survey on elderly mental health in Jeollanam-do (a southwest province in Korea) conducted by the Jeollanam-do Provincial Mental Health and Welfare Center. In total, 4,113 people were recruited from all 22 cities in Jeollanam-do. We evaluated sociodemographic factors and mental health status using self-reported questionnaires, namely, the Suicidal Ideation Scale, Geriatric Depression Scale-Short Form Korean Version, Multidimensional Scale of Perceived Social Support, Korean version of the General Health Questionale-12, and Satisfaction with Life Scale, to assess psychosocial factors affecting suicidal ideation. Multivariate logistic regression was performed to examine the factors associated with suicidal ideation.RESULTS: Among the 4,113 subjects, 325 (7.9%) reported recent suicidal ideation. Multivariate logistic regression analysis revealed that depression (p<0.001), low-level social support and life satisfaction (p=0.006), poor general mental health (p<0.001), physical disease (p=0.009), and poor self-perceived health status (p=0.039) were significantlyassociated with suicidal ideation.CONCLUSION: The presence of physical disease, poor self-perceived health status, depression, and poor general mental health conditions increase the risk of suicide ideation among the elderly. Social support and life satisfaction affected their suicidal ideation independently of depression.

Efficacy of Mirror Therapy Containing Functional Tasks in Poststroke Patients

OBJECTIVE: To investigate the effect of mirror therapy containing functional tasks on upper extremity function and activities of daily living in patients with subacute stroke. METHODS: The subjects were randomly divided into two groups: the mirror therapy group (30 patients) and the sham therapy group (30 patients). The mirror therapy group underwent a mirror therapy program together with conventional therapy for 20 minutes per day on 5 days per week for 4 weeks. The control group received a sham conventional therapy program under the same schedule as the mirror therapy group. The Fugl-Meyer Motor Function Assessment (FMA), Brunnstrom motor recovery stage, and Modified Barthel Index (MBI) were evaluated 4 weeks after the treatment. RESULTS: The upper extremity function on the affected side and ability to perform daily life activities after the intervention were significantly improved in both groups. After 4 weeks of intervention, improvements in the FMA (p=0.027) and MBI (p=0.041) were significantly greater in the mirror therapy group than the sham therapy group. CONCLUSION: In this study, we found that the mirror therapy containing functional task was effective in terms of improving the upper extremity functions and activities of daily living in patients with subacute stroke.

Effect of Custom-Molded Foot Orthoses on Foot Pain and Balance in Children With Symptomatic Flexible Flat Feet

OBJECTIVE: To evaluate the effect of custom-molded foot orthoses on foot pain and balance in children with symptomatic flexible flat foot 1 month and 3 months after fitting foot orthosis. METHOD: A total of 24 children over 6 years old with flexible flat feet and foot pain for at least 6 months were recruited for this study. Their resting calcaneal stance position and calcaneal pitch angle were measured. Individual custom-molded rigid foot orthoses were prescribed using inverted orthotic technique to control foot overpronation. Pain questionnaire was used to obtain pain sites, degree, and frequency. Balancing ability was determined using computerized posturography. These evaluations were performed prior to custom-molded foot orthoses, 1 month, and 3 months after fitting foot orthoses. RESULT: Of 24 children with symptomatic flexible flat feet recruited for this study, 20 completed the study. Significant (p<0.001) improvements in pain degree and frequency were noted after 1 and 3 months of custom-molded foot orthoses. In addition, significant (p<0.05) improvement in balancing ability was found after 3 months of custom-molded foot orthoses. CONCLUSION: Short-term use of custom-molded foot orthoses significantly improved foot pain and balancing ability in children with symptomatic flexible flat foot.