Social Isolation, Loneliness and Their Relationships with Mental Health Status in South Korea

Objective@#This study aims to investigate the prevalence and psychological impact of social isolation and loneliness in South Korea. Loneliness and social isolation have been regarded as a risk to both physical and mental health. However, most studies have focused on the elderly; hence, there are limited studies on the characteristics of socially isolated or lonely people considering age. @*Methods@#A sample of 1,700 participants was selected from three major cities in South Korea. In-person interviews were conducted to evaluate loneliness, social isolation and mental health status. @*Results@#Among the participants, the prevalence of social isolation and loneliness was 17.8% and 4.1%, respectively. Males decreased the odds of loneliness (AOR 0.49, 95% CI=0.28–0.87), while increasing the odds of social isolation (AOR 1.44, 95% CI=1.12–1.86) after adjusting for age and sex. Greater depressive and social phobic symptoms were associated with increased odds of loneliness and social isolation. @*Conclusion@#Social isolation and loneliness are prevalent among Koreans and associated with depression, social phobic symptoms, and suicidality. This study provides a foundation for further research to investigate nationwide prevalence and a more in-depth analysis of loneliness and social isolation.

The Stigma Against Social Withdrawal Syndrome (Hikikomori) Among Mental Health Practitioners / 신경정신의학

Objectives@#This study examined the stigma against social withdrawal syndrome (hikikomori) among mental health practitioners, and compared levels of stigma against social withdrawal syndrome versus mental illness. @*Methods@#The participants were 133 mental health practitioners (28 males, 105 females) with experience of social withdrawal syndrome that self-reported levels of stigma against social withdrawal syndrome and mental illness. @*Results@#Stigma against social withdrawal syndrome was generally significantly lower than stigma against mental illness. However, mental health practitioners tended to agree they would be reluctant to become personally involved with a person that had experienced social withdrawal syndrome (e.g., dating, hiring). Levels of stigma also differed across mental health occupations. @*Conclusion@#This study suggests although mental health practitioners may generally have less negative attitudes toward social withdrawal syndrome in the context of mental illness, that they may also have some reservations about personal interactions with individuals with social withdrawal syndrome.

Development and Validation of Loneliness and Social Isolation Scale / 신경정신의학

Objectives@#To develop a Loneliness and Social Isolation scale (LSIS) that can measure both social isolation and loneliness in order to understand the degree of social isolation in Korea. Exploratory and confirmatory factor analysis was used to examine the factorial validity of the scale. @*Methods@#The subjects of the study were 300 adults aged 19 or older who visited Samsung Medical Center and voluntarily expressed their willingness to participate in this research. Exploratory factor analysis (n=150) and confirmatory factor analysis (n=150) were conducted to construct the factorial structure model and to determine the model fit. @*Results@#Exploratory factor analysis showed a three-factor structure with a total variance of 65.8%; factor 1 consisted of social support, factor 2 of social networks, and factor 3 of items representing loneliness. After conducting confirmatory factor analysis on the three-factor models, a three-factor model consisting of 8 items (LSIS-8) and a three-factor model consisting of 6 items (LSIS-6) showed significant goodness-of-fit. Internal consistency for all items was good (Cronbach’s α=0.774), and correlations with existing social isolation and loneliness measures were significant. @*Conclusion@#This study is meaningful as provides a tool that comprehensively measures social support, social networks, and loneliness. We believe that the application of such tools that are relatively easy to apply in communities will aid understanding of the current state of social isolation and loneliness in Korea.

Social Isolation, Loneliness and Their Relationships with Mental Health Status in South Korea

Objective@#This study aims to investigate the prevalence and psychological impact of social isolation and loneliness in South Korea. Loneliness and social isolation have been regarded as a risk to both physical and mental health. However, most studies have focused on the elderly; hence, there are limited studies on the characteristics of socially isolated or lonely people considering age. @*Methods@#A sample of 1,700 participants was selected from three major cities in South Korea. In-person interviews were conducted to evaluate loneliness, social isolation and mental health status. @*Results@#Among the participants, the prevalence of social isolation and loneliness was 17.8% and 4.1%, respectively. Males decreased the odds of loneliness (AOR 0.49, 95% CI=0.28–0.87), while increasing the odds of social isolation (AOR 1.44, 95% CI=1.12–1.86) after adjusting for age and sex. Greater depressive and social phobic symptoms were associated with increased odds of loneliness and social isolation. @*Conclusion@#Social isolation and loneliness are prevalent among Koreans and associated with depression, social phobic symptoms, and suicidality. This study provides a foundation for further research to investigate nationwide prevalence and a more in-depth analysis of loneliness and social isolation.

Selective cyclooxygenase inhibitors increase paclitaxel sensitivity in taxane-resistant ovarian cancer by suppressing P-glycoprotein expression / 부인종양

OBJECTIVE: The purpose of this study was to investigate whether selective cyclooxygenase (COX) inhibitors promote paclitaxel-induced apoptosis in taxane-resistant ovarian cancer cells by suppressing MDR1/P-glycoprotein (P-gp) expression. METHODS: Taxane-resistant ovarian cancer cells were cultured with paclitaxel alone or combined with a selective COX inhibitors. The expression patterns of MDR1/P-gp and the ability of COX inhibitors to inhibit growth of taxane-resistant ovarian cancer cells were measured. The efficacy of prostaglandin E2 (PGE2) supplementation was measured to evaluate the mechanisms involved in suppressing MDR1 gene expression. RESULTS: P-gp was upregulated in taxane-resistant ovarian cancer cells compared to paired paclitaxel-sensitive ovarian cancer cells. An 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay showed that selective COX inhibitors significantly enhanced the cytotoxic effects of paclitaxel in taxane-resistant ovarian cancer cells via a prostaglandin-independent mechanism. These increased apoptotic effects were further verified by measuring an increased percentage of cells in sub-G1 stage using flow cytometry. Selective COX inhibitors suppressed MDR1 and P-gp expression. Moreover, combined treatment with paclitaxel and selective COX inhibitors increased poly (ADP-ribose) polymerase (PARP) cleavage in taxane-resistant ovarian cancer cells. CONCLUSION: Selective COX inhibitors significantly promote paclitaxel-induced cell death in taxane-resistant ovarian cancer cells in a prostaglandin-independent manner. COX inhibitors could be potent therapeutic tools to promote paclitaxel sensitization of taxane-resistant ovarian cancers by suppressing MDR1/P-gp, which is responsible for the efflux of chemotherapeutic agents.

Foot Deformity in Charcot Marie Tooth Disease According to Disease Severity

OBJECTIVE: To investigate the characteristics of foot deformities in patients with Charcot-Marie-Tooth (CMT) disease compared with normal persons according to severity of disease. METHOD: Sixty-two patients with CMT disease were recruited for this study. The normal control group was composed of 28 healthy people without any foot deformity. Patients were classified into a mild group and a moderate group according to the CMT neuropathy score. Ten typical radiological angles representing foot deformities such as pes equinus and pes varus were measured. The CMT group angles were compared with those of the normal control group, and those of the mild group were also compared with those of the moderate group. RESULTS: The lateral (Lat.) talo-first metatarsal angle, anteroposterior talo-first metatarsal angle, Lat. calcaneal-first metatarsal angle, Lat. naviocuboid overlap, Lat. calcaneal pitch, Lat. tibiocalcaneal angle, and Lat. talocalcaneal angle in the CMT group showed a significant difference compared to the normal control group (p<0.05). These findings revealed CMT patients have pes cavus, forefoot adduction, midfoot supination and pes varus deformity. Compared to the mild group, the moderate group significantly showed an increased Lat. calcaneal pitch and decreased Lat. calcaneal-first metatarsal angle, Lat. tibiocalcaneal angle, Lat. talocalcaneal angle, and Lat. talo-first metatarsal angle (p<0.05). These findings revealed that the pes cavus deformity of CMT patients tend to be worse with disease severity. CONCLUSION: The characteristic equinovarus foot deformity patterns in CMT patients were revealed and these deformities tended to be worse with disease severity. Radiographic measures may be useful for the investigation of foot deformities in CMT patients.

Impact of Environmental Tobacco Smoke Exposure and Home Environment on Asthma and Wheeze in School Children / 소아알레르기및호흡기학회지

PURPOSE: Environmental factors may increase risk for childhood asthma. The objective of this study was to investigate the association of environmental tobacco smoke (ETS) exposure and home environment with the development of wheeze and asthma. METHODS: We conducted a cross-sectional survey of 969 elementary school students. Data included questions about asthma and wheeze symptoms, exposure to tobacco smoke, and home environment including history of moving into a new house within 1 year of age after birth, use of fragrance at home, recent purchase of new furniture. Logistic regression and Pearson chi statistics were used to estimate these associations. RESULTS: ETS exposure was associated with current wheeze and nocturnal sleep disturbance. Paternal smoking over 20 cigarettes per day was associated with 4 or more episodes of wheeze during the past 1 year. However, there were no significant differences in pulmonary function, serum total IgE levels, blood eosinophil counts, and atopy between children with ETS exposure and non-exposure. Moving into a new house within 1 year of birth was associated with current asthma or wheeze. Use of fragrance at home and purchase of new furniture during the past 1 year were associated with current wheeze, current physician-diagnosed asthma, and nocturnal cough. CONCLUSION: Exposure to ETS, moving into a new house after birth, and indoor fragrance are risk factors for wheeze and asthma in schoolchildren.

Otolaryngological Manifestation of Hunter Syndrome / 대한이비인후과학회지

BACKGROUND AND OBJECTIVE: Hunter syndrome(mucopolysaccharidosis (MPS) type II) is a genetic, metabolic disease of excessive mucopolysaccharide storage leading to mental and skeletal abnormalities, distinctive facial features, hearing loss, and airway problems. Its eventual lethal outcome results from cardiac failure and progressive obstruction of the airway. We tried to outline the otolaryngologic manifestations and management of patients based on the results of our study and review of the relevant literature. MATERIALS AND METHODS: Nine patients with Hunter syndrome were included in this study. Every patient was interviewed for the evaluation of any abnormality in the head and neck region, intelligence and language. Audio tests, temporal bone CT, and plain films of cervical spine were also performed. RESULTS: Upper airway obstruction occurred in most of patients, and necessitated tonsillectomy and adenoidectomy in 4 patients. Tracheal narrowing occurred in 3 patients. Otitis media with effusion, hearing loss and thickening of the external auditory canal and tympanic membrane were commonly observed in patients, and ventilation tubes were inserted in 4 patients. Mental retardation was more profound in the severe type Hunter syndrome, but speech function was disordered in both severe and mild type. CONCLUSION: Accurate evaluation and management of airway obstruction is needed to prevent lethal airway problems. Aggressive audio and otological managements, including the management of otitis media, hearing aids and speech therapy are required to enhance communicative development and improve their quality of life.