A Short Review of Delirium in Patients With COVID-19

We reviewed the clinical features, prevalence, pathophysiology, and prevention and treatment of delirium in patients with coronavirus disease of 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19, has neurotropic properties, and can penetrate the central nervous system and affect brain neurons. These characteristics may explain the fact that COVID-19 patients may be particularly susceptible to delirium. COVID-19 delirium occurred more frequently in intensive care unit and emergency room settings. Patients with neurologic disorders and the elderly were more vulnerable to delirium. Clinical symptoms of COVID-19 delirium may manifest as a hyper/hypoactive type. Prevention and treatment appear to be similar to conventional treatment strategies. And the patient’s feeling of isolation due to social distancing and a highly intensive labor force of medical personnel must be overcome. Melatonin, alpha-2 agonist, antipsychotics, and valproic acid have been recommended for the treatment of delirium symptoms. However, this article did not go through a systematic literature review.

The Effect of Continuous Positive Pressure Therapy for Obstructive Sleep Apnea on Quality of Life : A Single-Institution Study / 수면정신생리

Objectives@#In this study, the clinical characteristics of OSA patients and the quality of life before and after CPAP use were compared to determine the degree of improvement in quality of life according to CPAP use. @*Methods@#Age, sex, height, weight, body mass index, Epworth Sleepiness Scale, Modified Mallampatti Score, Montreal Cognitive Assessment-Korean, and Pittsburgh Sleep Quality Index were compared between men and women through medical records. To understand the degree of improvement in quality of life resulting from use of CPAP, a personal telephone call was made to compare the VAS scores for quality of life before and after CPAP use. @*Results@#In height (HT) (Z = -4.525, p 0.05). The difference between AHI before and after CPAP was 36.48 ± 21.54 (t = 11.609, p < 0.001) and the difference between QOL before and after CPAP was –25.43 ± 22.06 (t = -7.901,p < 0.001), both of which were significant (p < 0.001). @*Conclusion@#Among OSA patients, there were differences in height (HT), weight (BW), sleep quality (PSQI), arousal index (AI), and severity of OSA between men and women, but the quality of life before and after CPAP was different. However, there was no difference between men and women in quality of life before and after CPAP. In addition, quality of life in OSA patients improved after using CPAP

The Effect of Continuous Positive Pressure Therapy for Obstructive Sleep Apnea on Quality of Life : A Single-Institution Study / 수면정신생리

Objectives@#In this study, the clinical characteristics of OSA patients and the quality of life before and after CPAP use were compared to determine the degree of improvement in quality of life according to CPAP use. @*Methods@#Age, sex, height, weight, body mass index, Epworth Sleepiness Scale, Modified Mallampatti Score, Montreal Cognitive Assessment-Korean, and Pittsburgh Sleep Quality Index were compared between men and women through medical records. To understand the degree of improvement in quality of life resulting from use of CPAP, a personal telephone call was made to compare the VAS scores for quality of life before and after CPAP use. @*Results@#In height (HT) (Z = -4.525, p 0.05). The difference between AHI before and after CPAP was 36.48 ± 21.54 (t = 11.609, p < 0.001) and the difference between QOL before and after CPAP was –25.43 ± 22.06 (t = -7.901,p < 0.001), both of which were significant (p < 0.001). @*Conclusion@#Among OSA patients, there were differences in height (HT), weight (BW), sleep quality (PSQI), arousal index (AI), and severity of OSA between men and women, but the quality of life before and after CPAP was different. However, there was no difference between men and women in quality of life before and after CPAP. In addition, quality of life in OSA patients improved after using CPAP

Effects of Perceived Stress, Sleep, and Depression on Resilience of Female Nurses in Rotating Shift and Daytime Fixed Work Schedules / 수면정신생리

OBJECTIVES@#Healthy sleep is important and can have a positive effect on resilience. The aim of the present study was to compare the differences in resilience between two group nurses in rotating shift and daytime fixed work schedules and to investigate stress perception, coping factors, social and psychological health, and sleep factors that may affect resilience.@*METHODS@#A total of 400 female nurses having rotating shift and daytime fixed work schedules at two hospitals was surveyed from June 12, 2017 to June 12, 2018. All participants completed perceived stress scale (PSS), stress coping short form (Brief COPE), psycho-social wellbeing Index short form (PWI-SF) or general health questionnaire-18 (GHQ-18), center for epidemiologic studies depression scale (CES-D), STAI-X-1 in state-trait anxiety inventory (STAI), Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), insomnia severity index (ISI), Conner Davidson resilience scale (CD-RISC). Independent t-test, paired t-test, Pearson correlation analysis, and multiple regression analysis were applied to the results of the final 373 questionnaires of 400 nurses in two general hospitals.@*RESULTS@#Comparing the variable statistics between the two groups of rotating shift and daytime fixed work nurses, showed statistically significant differences in all variables except perceived stress, sleep quality, and daytime sleepiness. Factors that had a significant correlation with resilience were stress coping strategies, depression, and insomnia severity (p < 0.001). In multiple regression analysis, larger positive reframing1 (β = 0.206, p < 0.001), severe less depression (β = −3.45, p < 0.001), and higher psychosocial health (β = 0.193, p < 0.001). As acceptance coping2 increased (β = 0.129, p < 0.05), as daytime sleepiness decreased (β = −1.17, p < 0.05), and as active coping2 increased (β = 0.118, p < 0.05), as the positive reframing2 increases (β = 0.110, p < 0.05), the resilience increased.@*CONCLUSION@#This study, it was found that resilience was higher in daytime fixed workers than in shift workers. In addition, specific stress coping strategies, psycho-social health, sleep, and depression factors were associated with resilience.

The Effects of Sleep Apnea and Variables on Cognitive Function and the Mediating Effect of Depression / 수면정신생리

OBJECTIVES: This study aimed to analyze causality among sleep apnea, depression and cognitive function in patients with obstructive sleep apnea. METHODS: We reviewed the medical records of 105 patients with sleep apnea and snoring who underwent overnight polysomnography (PSG). We analyzed various biological data, sleep variables (sleep duration and percentage) and respiratory variables [arousal index (AI), periodic leg movement index (PLM index), snoring Index (SI), mean SpO2, minimum SpO2, apnea-hypopnea index (AHI), and respiratory disturbance index (RDI)]. We also analyzed various data by sleep, cognition, and mood related scales: Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), snoring index by scale (SIS), Montreal Cognitive Assessment-Korean (Moca-K), Mini-mental State Examination-Korean (MMSE-K), clinical dementia rating (CDR), and Beck Depression Inventory (BDI). We analyzed causation among sleep, and respiratory, mood, and cognition related scales in obstructive sleep apnea patients. We analyzed the mediating effects of depression on sleep apnea patient cognition. RESULTS: As Duration N1 increased and Total sleep time (TST) decreased, MOCA-K showed negative causality (p < 0.01). As BDI and supine RDI increased, causality was negatively related to MOCA-K (p < 0.01). As PSQI (p < 0.001) and SIS (p < 0.01) increased and as MMSE-K (p < 0.01) decreased, causality was positively related to BDI. BDI was found to mediate the effect of age on MOCA-K in patients with obstructive sleep apnea. CONCLUSION: Duration N1, total sleep time, BDI, and supine RDI were associated with cognitive function in obstructive sleep apnea patients. Depression measured by BDI partially mediated cognitive decline in obstructive sleep apnea patients.

Effects of Total Thyroidectomy and Radioactive Iodine Therapy for Thyroid Cancer Patients on Sleep Apnea and Snoring / 신경정신의학

OBJECTIVES: Some paper claim thyroidectomy decreases snoring and sleep apnea symptoms and the opposite. The aim of this study is to evaluate and compare the effects of sleep apnea and snoring by total thyroidectomy and radioactive iodine (RI) therapy. METHODS: A total of 88 patients who underwent total thyroidectomy and RI therapy for thyroid cancer in the outpatient clinic of the department of surgery of a general hospital were recruited. Interviewers completed their demographic data, past medical history, and data on total thyroidectomy and sleep apnea with snoring, and also preoperative and postoperative Pittsburgh Sleep Quality Index (PSQI), preoperative and postoperative Epworth Sleepiness Scale (ESS), preoperative and postoperative Snoring Index (SI), preoperative and postoperative global life satisfaction (index of well-being) scale, and postoperative Beck Depression Inventory. RESULTS: The Wilcoxon Signed Ranks Test showed PSQI preoperative-postoperative p=0.750, ESS preoperative-postoperative p=0.000, SI preoperative-postoperative p=0.034, life satisfaction preoperative-postoperative p=0.216 (based on negative ranks). CONCLUSION: The above results indicate that snoring and daytime sleepiness increased after total thyroidectomy and RI therapy, suggesting that the patency of upper airway (UA) was reduced or the collapsibility of the UA increased after total thyroidectomy and RI therapy. That is, the above results indicate that sleep apnea and snoring were aggravated after total thyroidectomy and RI therapy.

Psychosomatic Symptoms of Rotating Shift and Daytime Working Nurses in a General Hospital / 정신신체의학

OBJECTIVES: Shift work disorder occurs when you have difficulties adjusting to a work schedule that takes place during a time which most people sleep. Some people may have diverse psychosomatic symptoms, such as sleep problems, depression, anxiety, and headaches even after the shift work schedule ends. The aims of this study are to compare difference of psychosomatic symptoms between rotating shift and daytime working nurse groups. METHODS: Volunteer nurses working in a general hospital were recruited in a general hospital. We collected sociodemographic data. We used questionnaires for headache type, headache frequency, and VAS(Visual Analog Scale) for headache intensity, BDI(Beck depression Inventory) and GSAQ(Global Sleep Assessment Questionnaire). We used Mann-Whitney test and Chi-square test for hypothesis testing. RESULTS: Data collected from 84 women nurses. Rotating shift(N=37) working nurses showed younger, more unmarried, and shorter work periods than daytime working nurses (N=47). Also rotating shift group showed more problems of headache, insomnia, excessive daytime sleepiness, depression and anxiety than daytime group. The above results were statistically significant. CONCLUSIONS: The rotating shift work women nurses produced more headache, insomnia, excessive daytime sleepiness, depression, and anxiety than daytime working ones.

The Effects of Sociodemographic Factors on Psychiatric Diagnosis

OBJECTIVE: Several studies have reported that ethnic differences influence psychiatric diagnoses. Some previous studies reported that African Americans and Hispanics are diagnosed with schizophrenia spectrum disorders more frequently than Caucasians, and that Caucasians are more likely to be diagnosed with affective disorders than other ethnic groups. We sought to identify associations between sociodemographic factors and psychiatric diagnosis. METHODS: We retrospectively examined the medical records of all psychiatric inpatients (ages over 18 years) treated at Kern county mental hospital (n=2,051) between July 2003 and March 2007 for demographic, clinical information, and discharge diagnoses. RESULTS: African American and Hispanic males were more frequently diagnosed with schizophrenia spectrum disorders than Caucasians, whereas Caucasian females were more frequently diagnosed with affective disorders than females in the other ethnic groups, suggesting that patient ethnicity and gender may influence clinical diagnoses. Demographic variables, that is, a lower education, failure of marriage, homelessness, and low quality insurance, were found to be significantly associated with a diagnosis of schizophrenia spectrum disorders after adjusting for clinical variables. And, the presence of a family psychiatric history, failure of marriage, not-homelessness, and quality insurance were found to be associated with a diagnosis of affective disorders. CONCLUSION: Our results show that these demographic factors, including ethnicity, have effects on diagnoses in psychiatric inpatients. Furthermore, these variables may help prediction of psychiatric diagnoses.

Common Features of Attention Deficit Hyperactivity Disorder and Epileptic Disorder in Childhood and Early Adolescence / 정신신체의학

OBJECTIVES: We conduct this study to investigate the common features between Attention Deficit Hyperactivity Disorder(ADHD) and epileptic patients compared to normal control. METHODS: Epileptic patients were recruited from the department of pediatic in Jesus Hospital. ADHD patients were recruited from the department of neuropsychiatry in Jesus Hospital. We excluded mental retardation or brain organic pathology. We use ADHD Diagnostic System and Korean-Child Behavior Checklist(K-CBCL) to assess features of ADHD. Electroencephalogram(EEG) of ADHD, epileptic patients and normal control were analyzed and compared. RESULTS: Compared to normal control group, inattention, reaction time deviation were increased in both ADHD and epilepsy group. EEG abnormalities(control 13.8%, epilepsy 97.1%, ADHD 40%) in three groups were reported. CONCLUSION: There are common features of ADHD and epileptic patients.

The Reliability and Validity of Korean Version of Paruresis Check list (K-PCL) / 신경정신의학

OBJECTIVES : Paruresis (or Shy bladder syndrome) is characterized by the inability to urinate in the public lavatory. The Paruresis Checklist (PCL) is the only tool that screens for this disorder. The aim of this study was to assess the reliability and validity of the Korean Version of the Paruresis Checklist (K-PCL), and to examine characterstics of this disorder. METHODS : 530 males were enrolled in this study. We administered the K-PCL, the Social Avoidant and Distress scale (SAD), and the Beck Anxiety Inventory (BAI). The Case group included individuals whos PCL score was > or =5. Statistical analyses were performed to compare the BAI and Korea-Social Avoidance and Distress (K-SAD) scores of each group using 2-way ANOVA and Scheffe methods. RESULTS : The K-PCL score ranged from 0 to 6, with a mean 0.75. The Cronbach alpha coefficients of the K-PCL were .72, SAD .74 and BAI .73. A total of 8 males (1.51%) were included in the case group. Comparison of the case and control groups showed a significant difference in BAI scores, but no significant difference in K-SAD scores. CONCLUSION : The K-PCL showed a significant reliability and validity for paruresis. However, our results were not consistent with the notion that paruresis is a special form of social phobia.

The Reliability and Validity of Korean Version of Paruresis Check list (K-PCL) / 신경정신의학

OBJECTIVES : Paruresis (or Shy bladder syndrome) is characterized by the inability to urinate in the public lavatory. The Paruresis Checklist (PCL) is the only tool that screens for this disorder. The aim of this study was to assess the reliability and validity of the Korean Version of the Paruresis Checklist (K-PCL), and to examine characterstics of this disorder. METHODS : 530 males were enrolled in this study. We administered the K-PCL, the Social Avoidant and Distress scale (SAD), and the Beck Anxiety Inventory (BAI). The Case group included individuals whos PCL score was > or =5. Statistical analyses were performed to compare the BAI and Korea-Social Avoidance and Distress (K-SAD) scores of each group using 2-way ANOVA and Scheffe methods. RESULTS : The K-PCL score ranged from 0 to 6, with a mean 0.75. The Cronbach alpha coefficients of the K-PCL were .72, SAD .74 and BAI .73. A total of 8 males (1.51%) were included in the case group. Comparison of the case and control groups showed a significant difference in BAI scores, but no significant difference in K-SAD scores. CONCLUSION : The K-PCL showed a significant reliability and validity for paruresis. However, our results were not consistent with the notion that paruresis is a special form of social phobia.

A Study of Reliability and Validity on the Korean Version of Clinician Administered PTSD Scale for Children and Adolescents / 신경정신의학

OBJECTIVES: This present study was conducted to explore the reliability and the validity of Clinician Administered PTSD Scale for Children and Adolescents Korean version (CAPS-CA). METHODS: The Subjects were children and adolescents (8-13yrs) from different places: a certain elementary school, three orphanages, a general hospital, and two neuropsychiatric local clinics. Only subjects who experienced a catastrophic traumatic event were tested by CAPS-CA, CDI, RCMAS, and TSC. RESULTS: The range of correlations between item-criterion were .67-.84. The coefficients of internal consistency were .87. and test-retest reliability was .90, were all the coefficients in the proper range. Inter-correlations of CAPS-CA, CDI, RCMAS, and TSC scale showed significant correlation. TSC showed the highest correlation coefficient. CAPS-CA can be a useful clinician- administered diagnostic instrument for children and adolescents PTSD symptoms. CONCLUSION: The reliability and the validity of CAPS-CA were confirmed. CAPS-CA could be applied for diagnostic purposes of PTSD in children and adolescents.

A Study on Reliability and Validity of the Korean Version of Impact of Event Scale-Revised / 신경정신의학

OBJECTIVES: The present study was conducted to explore the reliability and validity of the "Impact of Event Scale-Revised Korean version" (IES-R-K). METHODS: The subjects were college students who visited a college counseling center and patients who were admitted to a general hospital and two orthopedic local clinics. Those subjects who experienced catastrophic traumatic events were tested for CAPS, BDI, STAI-I, II, and MMPI-PTSD scale. RESULTS: The range of correlations between item-total were .45-.89. The coefficients of internal consistency were .69-.83, of them were the Split-half reliability was .71 and the test-retest reliability was .89, all within expected ranges. Inter-correlations of IES-R-K, CAPS, BDI, STAI-I, II, and MMPI-PTSD scale were high. CAPS showed the highest correlation coefficient. Factor analysis indicated 4 factors in IES-R;avoidance, hyperarousal, intrusion, and sleep problem & numbness. IES-R-K can be a useful self-rating diagnostic instrument for PTSD symptoms to be a clinical concern by using 24/25 cutoff in total score. The partial PTSD cutoff score is 17/18. CONCLUSION: The IES-R-K was confirmed in it's reliability and validity. IES-R-K could be applied for screening of PTSD.

Relations between Demographic, Clinical, Psychopathological Characteristics and the Ways of Coping for Psychosocial Adjustment in Epileptic Patients / 대한간질학회지

PURPOSE: The purpose of this study is to understand the relations of demographic and clinical characteristics, psychopathology and ways of coping with psychosocial adjustment of epileptic patients. METHODS: The participants were 200 epileptic outpatients. They completed Korean version of Washington Psychosocial Seizure Inventory (K-WPSI), Symptom Check List-90-Revised (SCL-90-R) and The Ways of Coping Checklist (WCC). RESULTS: The results showed that frequency of seizure, education level, socioeconomic level, occupation, all of subscales in SCL-90-R and passive coping styles were significantly related to overall psychosocial functioning of epileptic patients. The global severity index score that indicated present psychopathology of SCL-90-R best explained overall psychosocial functioning. And the frequency of seizure, education level, socioeconomic level, occupation, and somatization were also significant factors. The global severity index score was explained by emotional focused coping, socioeconomic level, frequency of seizure, and problem focused coping. CONCLUSIONS: The results of this study suggested that psychosocial adjustment of epileptic patients showed a significant relations with psychopathology, clinical and socioeconomic factors and the ways of coping.

The validity and Reliability on Korean Version of Washington Psychosocial Seizure Inventory: Cross-Cultural Comparisons / 대한간질학회지

PURPOSE: The aim of this study was 1) to confirm the reliability and validity of a Korean version of Washington Psychosocial Seizure Inventory (K-WPSI), 2) to investigate the psychosocial functioning of epilepsy patients from Korea, and 3) to compare with other countries. METHODS: The subjects were 302 patients with epilepsy (above 18years). They completed K-WPSI of 132 items including 11 subscales:family background, emotional adjustment, interpersonal adjustment, adjustment to seizures, medical management, overall psychological functioning, Blank, Lie and Rare. We assessed internal consistency, item-subscale correlations, and split-half reliability. Construct validity was assessed by correlating scales of Psychosocial Rating Sheet and K-WPSI. K-WPSI profiles were compared with those from the West Germany, Finland, Canada, the United States, Chile, Dutch, and Japan. RESULTS: The internal consistency estimated by cronbach's alpha coefficient was .934 and split-half reliability coefficient was .876 for adequate reliability (p<.01). Each of subscales in the K-WPSI were high correlated with theoretically similar scales but correlation between theoretically dissimilar subscales was not high. And K-WPSI subscales were significantly related to the PRS subscales. It showed that the Korea epilepsy patients had serious problems in emotional, interpersonal, vocational adjustment, financial status, adjustment to seizure, and overall psycho-social functioning. Comparing the outcomes of various countries, epilepsy patients from Korea and chile had the most serious problem in most areas of psychosocial functioning. CONCLUSIONS: K-WPSI could be a useful test in Korea for reliable determination of the various psychosocial problems of epilepsy patients but modifications of the limitation of the Lie scale may be needed. Comparing the results of other countries, Korea epilepsy patients have been experienced serious psychosocial problem. To solve this problem, social policy and medical and emotional supportive system for persons with epilepsy should need to be established.

The Preliminary Study of Reliability and Validity on the Korean Version of Personality Disorder Questionnaire-4+ (PDQ-4+) / 신경정신의학

OBJECTIVES: The purpose of this study was to examine the reliability and the validity of the Korean version of Personality Disorder Questionnaire-4+ (PDQ-4+). METHODS: PDQ-4+ was administered to 540 subjects of general population group and 37 subjects of personality disorder group. For measuring concurrent reliability, we tested internal consistency, split-half reliability, test-retest reliability and correlation of item score of subscale and mean of subscale. And also, we performed factor analysis for the evaluation of validity, and t-test to group difference of the total scores between general population group and personality disorder group. RESULTS: In general population group and personality disorder group, internal consistency was above .500 (range of Cronbach alpha: .4007 to .6693) in most of the Personality disorder categories. Split-half reliability was .839 between even and odd items. Test-retest reliability done 2 weeks interval was .868. Item scores of subscales and mean of subscales showed high correlation coefficient. Group difference of the total scores between general population and personality disorder group showed very significant difference (t=9.146, df=76, p=.000). CONCLUSION: The PDQ-4+ shows a reasonable degree of reliability and validity and could be a valuable tool in screening for overall personality disturbances.