Associations of Premenstrual Dysphoric Disorder with Quality of Life, Socio-Occupational Function and Disability in Nurses / 신경정신의학

OBJECTIVES: This study aimed to investigate the prospective associations of premenstrual dysphoric disorder (PMDD) with quality of life, socio-occupational function and disability. METHODS: 170 nurses were recruited from two general hospitals. Interviews were made at baseline and at four follow-up points (two mid follicular phases and two late luteal phases of the two consecutive menstrual cycles). The baseline evaluation consisted of sociodemographic characteristics and menstrual history. PMDD was diagnosed by DSM-IV criteria after observation of the two menstrual cycles. The follow-up evaluations were consisted of the World Health Organization Quality of Life-Brief form, the Social and Occupational Functioning Assessment Scale, and the World Health Organization Disability Assessment Scale-II. RESULTS: PMDD was detected 15 (8.8%) of 170 participants. The PMDD group showed significantly worse quality of life and socio-occupational functioning than the none-PMDD group particularly at the late luteal phases. No significant differences were found in sociodemographic characteristics and menstrual history between those with and without PMDD. CONCLUSION: PMDD was prospectively associated with worse quality of life and socio-occupational functioning in this study group.

Requests for Child Abuse Education in Medical School Curricula

OBJECTIVES: This study aimed to examine current educational experiences, knowledge, intention to report, and requests for child abuse education in medical interns. METHODS: A descriptive cross-sectional study was conducted in 2006 and 2007. The study sample consisted of 193 medical interns who served their internships at the university hospital. They answered 11 self-administered questionnaires related to child abuse. RESULTS: Although respondents indicated a strong will to assist in eradicating abuse of children, about 90% had no educational experiences and knowledge of child abuse. Ignorance was a major factor for low reported cases of abused children. The preferred nominated reporting agency for child abuse was the National Child Protection Agency in 47.9% of female respondents, while 48.3% of males nominated Police Stations as their preferred option. In relation to sexual abuse, Police Stations were the preferred reporting agency by 49.2% of males and 37.0% of females. Medical school curricula were chosen by the majority of interns as the most appropriate stage where child abuse education should be introduced. CONCLUSION: This study found that medical graduates had limited experience and knowledge related to child abuse. The medical school curricula for child abuse needs to be further developed, implemented, and evaluated when appropriate.

Effects of Vascular Risk Factors on Advancing Age Associated Cognitive Decline: A Longitudinal Study in a Community Dwelling Older Population

OBJECTIVE: This study aimed to investigate the association between cognitive decline and advancing age, and the potential effects of vascular risk factors on the associations. METHOD: 1134 old persons aged 65 or over was assessed by the Korean version of Mini-Mental State Examination (MMSE-K) in 1999, and after two years 686 (61%) of the total subjects were reassessed with MMSE-K. Data on age and vascular risk factors (hypertension and diabetes) was obtained. RESULTS: Cognitive decline was significantly associated with advancing age. The stratified analyses showed that the association of cognitive decline with advancing age was significant for those with vascular risk factors, but not significant for the subjects without vascular risk factors. CONCLUSION: We suggest that the cognitive decline with advancing age might be delayed by appropriate management for the vascular risk factors.

Prevalence Rate and Risk Factors of Dementia Compared between Urban and Rural Communities of the Metropolitan Kwangju Area / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the prevalence rate and risk factors of dementia in an urban and a rural sample of older persons in the metropolitan Kwangju area, Republic of Korea. In addition, the prevalence rate and risk factors of dementia between the two samples were compared. METHODS: A two-phase epidemiological study of residents aged 65 or over(N=1,598) was conducted in a highly developed, urban and a non-contiguous, poorly developed, rural area of metropolitan Kwangju. In the first(screening) phase, 38 trained research assistants collectively performed in-home interviews for all participants. Detailed sociodemographic characteristics were gathered and the Korean version of Mini-Mental State Examination(MMSE-K) was administered. In the second(diagnosing) phase, diagnosis of dementia was established for those scoring 24 or less on the MMSE-K in the screening phase(N=431), and etiological types of dementia were classified to Alzheimer's disease (AD), vascular dementia(VaD) or miscellanous type by two teams of experts. Prevalence rate of dementia was determined in the participants, and age-standardized prevalence rate adjusted by age distribution in metropolitan Kwangju was estimated. For AD, the risk factors were investigated in all participants, and analyses were repeated for the urban and rural samples separately. RESULTS: The participating rates in the first and second phases were 71.0%(N=1,134) and 83.2% (N=410), respectively. In the participants, the prevalence rates of dementia(all types), AD and VaD were 9.7%, 5.2% and 1.8%, respectively. The age-standardized prevalence rates were 10.7%, 5.7% and 1.9%, respectively. Aging, female gender and no education(complete lack of formal education) were identified as independent risk factors for AD. No difference between the urban and rural samples was observed in the prevalence rates of dementia(all types), AD and VaD. However, risk factors for AD differed between these areas. In the urban sample, no education was the only significant factor; whereas, aging and female gender were identified as risk factors in the rural sample. CONCLUSION: A high prevalence rate of dementia was observed among old persons in metropolitan Kwangju, consistent with previous studies conducted in other Korean areas. The risk factor profiles for AD differed between urban and rural settings. The results of this study reflect the current status of dementia in Korea and suggests that appropriate management and prevention strategies for dementia should be tailored toward the geographic settings.