Brief Screening for Four Mental Illnesses of the Elderly in Community Mental Health Services: the BS4MI-Elderly

Objective@#Early detection and proper management of mental illness can help to prevent severe deterioration. However, with limited financial and human resources of community mental health services, it is not practical to carry out all conventional screening tools simultaneously. In this study, we aimed to develop and validate a brief but comprehensive screening questionnaire for four common mental illnesses of the elderly. @*Methods@#The brief screening for four mental illnesses of elderly (BS4MI-elderly) is a 14-item binary response questionnaire that covers dementia, depressive disorder, sleep disorder, and hwa-byung. To test validity, we compared conventional scale scores for three groups of participants classified using the BS4MI-elderly. The sensitivity, specificity, predictive value of positive test, likelihood ratio of positive test and internal consistency of the BS4MI-elderly were assessed. Finally, a correlation analysis between the BS4MI-elderly and general mental health scales was conducted. @*Results@#A total of 254 participants aged over 65 years were recruited. The BS4MI-elderly showed moderate to high sensitivity for the test that distinguishes the normal group from the risk and disorder groups (dementia: 0.61, depressive disorder: 0.88, sleep disorder: 0.85, hwa-byung: 0.94) and high specificity for the test that distinguishes the disorder group from the normal and risk groups (dementia: 0.91, depressive disorder: 0.93, hwa-byung: 0.84, sleep disorder: 0.84). The BS4MI-elderly also exhibited good internal consistency and significant correlations with general mental health scales. @*Conclusion@#The BS4MI-elderly, a brief but comprehensive screening tool, could be a useful instrument for screening the elderly in community mental health services.

Assault-related Factors and Trauma-related Cognitions Associated with Post-traumatic Stress Symptoms in High-distress and Low-distress Korean Female Victims of Sexual Assault

Background@#Information about the factors involved in the progress of both high distressed and low distressed victims in the early days after a sexual assault are needed to provide effective intervention for victims of sexual assault. In this study, we examined the relationship among posttraumatic stress disorder (PTSD) symptoms, assault-related factors and trauma-related cognitions in Korean female victims of sexual assault. @*Methods@#For this study, we retrospectively investigated the records of 94 female victims from the Sunflower Center for Women and Children Victims of Violence at the Ajou University Hospital in Korea. Demographic characteristics and the features of the sexual assault, post-traumatic stress symptoms, and trauma-related cognition were obtained from data recorded at the initial assessment. One month after the initial assessment, victims were contacted by telephone and their PTSD symptom severity was re-evaluated. The sample of 94 participants were divided into two groups depending on the PTSD symptom scale scores at initial assessment: High-distress group and Low-distress group. @*Results@#Repeated-measured analyses of variance revealed that the high-distress group showed a decrease in PTSD symptom severity over the month, while the low-distress group did not show significant change of PTSD symptom severity. In correlation analysis, negative thoughts and beliefs about the assault were strongly correlated with PTSD symptom severity one month later in both the low-distress and high-distress groups. @*Conclusion@#Our results suggest that trauma-related cognitions seem to play an important role in the maintenance of PTSD both of high-distress and low-distress groups, and that effective intervention will need to address these cognitive factors.

Effect of Community-Based ‘Goal-Achieving Program’ in Patient with Late-Life Depression : Preliminary Study

OBJECTIVE: This study aimed to investigate the effect of community-based Goal-Achieving program in geriatric depressive symptoms preliminarily. METHODS: We obtained data from elderly Korean subjects with major depressive disorder (n=51) aged 60 years or older at baseline, taking case management from community mental health center. Subjects were randomly assigned to intervention group (n=24) and control group (n=27). We investigated depressive symptoms through Short Form Geriatric Depression Scale-Korean version (SGDS-K) at baseline and every month for 3 months to all subjects. We tested interaction between group and time in SGDS-K score to evaluate the effect of program. And post hoc test examined between group differences of SGDS-K at each time points. RESULTS: In quadratic linear mixed effects model analysis, interaction between group and time was statistically significant (Total SGDS-K score : coefficient=0.29, p<0.001 ; SGDS-K dysphoria subscale : 0.18, p<0.001 ; SGDS-K hopelessness subscale : 0.05, p=0.089 ; SGDS-K cognitive impairment subscale : 0.06, p=0.003). And significant between group difference was shown in post hoc test at time points of third month (SGDS-K score of control group : SGDS-K score of intervention group=10.74±3.482 : 7.25±4.475, p=0.0184). CONCLUSION: These results may suggest that ‘Community-based the Goal-Achieving program’ has efficacy in reducing geriatric depressive symptoms.

Post-Traumatic Cognition Mediates the Relationship between a History of Sexual Abuse and the Post-Traumatic Stress Symptoms in Sexual Assault Victims

More than half of all sexual assault victims report experiencing sexual victimization more than once. The aim of this paper was to determine the role post-traumatic cognition plays in the relationship between a history of sexual abuse and post-traumatic stress symptoms in sexual assault victims. The relationship between a history of sexual assault and the severity of post-traumatic stress symptoms was investigated retrospectively using data from a sexual assault crisis center in Korea. Data on psychological symptoms were collected in person at the initial assessment and by telephone 1 month later using the Post-traumatic Cognitions Inventory and the Post-traumatic Stress Disorder Symptoms Scale: Self-report Version. Of 105 women included in the analysis, 10 (9.5%) reported prior sexual abuse and were classified as sexually revictimized. Revictimized women had more post-traumatic negative cognition at initial assessment (t = −2.98; P = 0.004) and more post-traumatic symptoms at 1 month follow-up (t = −2.39; P = 0.019) than singly victimized women. At 1 month follow-up, the severity of post-traumatic stress symptoms had increased in revictimized women but had decreased slightly in singly victimized women. Negative post-traumatic cognition fully mediated the association between a history of sexual abuse and the severity of post-traumatic stress symptoms. Early detection of sexually revictimized women and tailored service and treatment intervention is needed to better serve this group of victims. Interventions targeted at preventing revictimization or post crime victimization may also help victims recover from the trauma and prevent future abuse.

The Relationship between Late-Life Depression and Resilience

OBJECTIVE: The aim of this study was to examine the relationship between late-life depression and resilience in the Korean community-dwelling elderly with depression. METHODS: The subjects were 102 depressed elderly people who lived in Suwon and Gwangju, Korea. Each subject was administered the questionnaires regarding the socio-demographic characteristics, Korean version of the Mini-Mental State Examination for Dementia Screening (MMSE-DS), Brief Resilience Scale (BRS), and Short Form Geriatric Depression Scale-Korean version (SGDS-K). RESULTS: In a cross-sectional aspect, BRS score were negatively correlated with SGDS-K score in the Pearson's correlation test (r=-0.301, p=0.002). After multivariable adjustments, linear mixed model analysis showed that subjects with baseline higher BRS score had significantly lesser SGDS-K score (β=-0.16, p=0.006). CONCLUSION: The level of resilience should be considered in predicting the change of depressive symptoms in the elderly.

Association between Alcohol Use Disorder and Cognitive Function According to Gender in the Elderly

OBJECTIVE: This study aims to investigate the association between alcohol use disorder and cognition in Korean community-dwelling elderly, especially the gender-specific difference. METHODS: Data obtained from 1,141 subjects (976 men and 165 women) aged above 60 years was analyzed from the Gwangju Dementia and Mild Cognitive Impairment Study. All subjects completed the study questionnaire including demographic characteristics, history of current and past illnesses, drug history, Korean Mini-Mental State Examination (K-MMSE), and cut down, annoyed, guilty feelings, eye-opener (CAGE), Short Form of Geriatric Depression Scale-Korean version (SGDS-K). RESULTS: Of the 1,141 subjects (mean age 72.17±6.20, mean educational level 6.50±4.48), 267 demonstrated alcohol use disorder (23.40%) and 874 were non-alcohol use disorder (76.60%). The mean of K-MMSE for alcohol use disorder group was 23.23±4.99, and for non-alcohol use disorder group was 23.70±3.94. When alcohol use disorder is accompanying, the decrement of K-MMSE score was 3.07 for female, and 0.35 for male. And we confirmed the interactive effect on K-MMSE score between sex and alcohol use disorder after adjusting for age, education level, depression (F=5.798, p=0.016). CONCLUSION: In conclusion, our study demonstrates an association between alcohol use disorder and cognitive impairment by gender in the elderly.

The Relationship between Temporal Discounting and Well-Being in the Elderly

OBJECTIVE: This study aims to examine association of temporal discounting with well-being of Korean community-dwelling elderly. METHODS: The subjects of this research were 4,373 community-dwelling older persons without dementia. Each subject was administered the questionnaires regarding the socio-demographic characteristics, temporal discounting which was measured using standard questions in which participants were asked to choose between an immediate, smaller payment and a delayed, larger one. Outcome variable is Korean version of the World Health Organization Five Well-Being Index (WHO-5). Statistical analyses including the Pearson's correlation test and logistic regression were performed in this study. RESULTS: At baseline, temporal discounting was negatively associated with WHO-5 in the Pearson's correlation test (r=-0.04, p=0.006). In a adjusted model for confounding variables, temporal discounting was negatively associated with WHO-5 [odd ratio (95% confidence interval)=0.57 (0.35–0.92), p=0.021]. CONCLUSION: Elderly individual with a higher temporal discounting (which indicates impulsivity) may have a lower quality of life.

Depression as a Mediator of the Relationship Between Resilience and Posttraumatic Stress Symptoms and Dissociation in Firefighters / 정신신체의학

OBJECTIVES: This study aimed to investigate the effects of resilience on posttraumatic stress symptoms and dissociation and whether depression mediates the relationships between resilience and posttraumatic stress symptoms and dissociation. METHODS: A total of 115 firefighters participated in the study. Data were collected via the Life Events Checklist, Impact of Event Scale-Revised, Dissociative Experience Scale, Beck Depression Inventory, and Connor-Davidson Resilience Scale. Structural equation modeling and path analysis were applied to estimate the relationships between resilience, depression, posttraumatic stress symptoms, and dissociation. RESULTS: Greater resilience was associated with lower posttraumatic stress symptoms and dissociation, and the relationship between them was fully mediated by depression. CONCLUSIONS: Specific aspects of depression may help explain the relationships between resilience and posttraumatic stress symptoms and dissociation. Tailored prevention programs and treatments based on resilience and depression may prevent posttraumatic stress symptoms and dissociation in firefighters and improve treatments outcomes among firefighters with posttraumatic stress symptoms and/or dissociation.

The Effects of Stressors on Subjective Well-Being in the Elderly

OBJECTIVE: This study aims to identify self-reported stressors in the Korean community-dwelling elderly and examine their effects on subjective well-being. METHODS: The subjects of this research were 1,010 elderly people who lived in Suwon, Korea. Each subject was administered the questionnaires regarding the socio-demographic characteristics, self-reported stressors, Concise Measure of Subjective Well-Being (COMOSWB) consisting of life satisfaction, positive emotion and negative emotion, Mini-Mental State Examination for dementia screening and Short Form Geriatric Depression Scale-Korean version. Statistical analyses including the Pearson's correlation test and multiple linear regressions were performed in this study. RESULTS: In our adjusted model for confounding variables, stress from physical problems (S-PP) (ss=-0.133, p<0.001), stress from loneliness or solitude (S-LS) (ss=-0.077, p=0.007), stress from family members (S-FM) (ss=-0.083, p=0.001) were negatively associated with the total score of COMOSWB. In subscale analyses of COMOSWB, we also found that S-PP (ss=-0.184, p<0.001), S-LS (ss=-0.077, p=0.014), stress from economic problems (ss=-0.072, p=0.021) were negatively associated with life satisfaction score. While S-PP (ss=-0.140, p<0.001) and S-FM (ss=-0.079, p=0.003) were negatively associated with positive emotion score, S-FM (ss=0.105, p=0.001) and stress from friends and neighbors (ss=0.072, p=0.016) were positively associated with negative emotion score. CONCLUSION: Stresses from physical problems, loneliness, and family members might be associated with subjective well-being in the elderly. While life satisfaction appears to be affected by one's perceived physical health status, loneliness, and economic conditions, positive and negative emotions appear to be affected by relationships with family members, friends, or neighbors.

Correlation between Head Circumference and Cognition in the Elderly

OBJECTIVE: Head circumference (HC) has been reported to be an index of cognitive functioning in the elderly and in Alzheimer's patients. The object of the study is to find the relationship between HC and cognition. METHODS: A total of 7,603 subjects over 60 years of age were analyzed from preliminary data of Gwangju Dementia and Mild Cognitive Impairment Study. HC was manually measured and cognitive functioning was assessed by the Korean version of the Mini Mental State Examination (K-MMSE). RESULTS: Correlational analysis showed that HC was associated with age (r=-0.14, p<0.01), education (r=0.33, p<0.01), height (r=0.26, p<0.01), and K-MMSE (r=0.28, p<0.01). Also, even after adjusting for confounding variables (age, education, height, gender) the positive association between HC and K-MMSE score remained significant (beta=0.18, p<0.001). CONCLUSION: The results suggest that HC may play an important role in predicting cognitive impairment in the elderly.

A Pilot Prospective Study of the Relationship among Cognitive Factors, Shame, and Guilt Proneness on Posttraumatic Stress Disorder Symptoms in Female Victims of Sexual Violence

This study prospectively examined the relationships among cognitive factors and severity of Posttraumatic stress disorder (PTSD) symptoms in female victims of sexual violence. Thirty-eight victims of sexual violence recruited from Center for Women Victims of Sexual and Domestic Violence at Ajou University Hospital. Cognitive factors and PTSD symptom were assessed within 4 months of sexual violence and 25 victims were followed-up 1 month after initial assessment. Repeated-measured ANOVA revealed that PTSD incidence and severity decreased over the month (F [1, 21]=6.61). Particularly, avoidant symptoms might decrease earlier than other PTSD symptoms (F [1, 21]=5.92). This study also showed the significant relationship between early negative trauma-related thoughts and subsequent PTSD severity. Shame and guilt proneness had significant cross-sectional correlations with PTSD severity, but did not show associations when depression severity is controlled. Our results suggest that avoidant symptoms might decrease earlier than other PTSD symptoms during the acute phase and that cognitive appraisals concerning the dangerousness of the world seem to play an important role in the maintenance of PTSD (r=0.499, P<0.05).

Difficulty in Facial Emotion Recognition in Children with ADHD

OBJECTIVES: It is known that children with attention-deficit hyperactivity disorder (ADHD) experience significant difficulty in recognizing facial emotion, which involves processing of emotional facial expressions rather than speech, compared to children without ADHD. This objective of this study is to investigate the differences in facial emotion recognition between children with ADHD and normal children used as control. METHODS: The children for our study were recruited from the Suwon Project, a cohort comprising a non-random convenience sample of 117 nine-year-old ethnic Koreans. The parents of the study participants completed study questionnaires such as the Korean version of Child Behavior Checklist, ADHD Rating Scale, Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. Facial Expression Recognition Test of the Emotion Recognition Test was used for the evaluation of facial emotion recognition and ADHD Rating Scale was used for the assessment of ADHD. RESULTS: ADHD children (N=10) were found to have impaired recognition when it comes to Emotional Differentiation and Contextual Understanding compared with normal controls (N=24). We found no statistically significant difference in the recognition of positive facial emotions (happy and surprise) and negative facial emotions (anger, sadness, disgust and fear) between the children with ADHD and normal children. CONCLUSION: The results of our study suggested that facial emotion recognition may be closely associated with ADHD, after controlling for covariates, although more research is needed.

Sociodemographic Characteristics and Emotional and Behavioral Factors Associated with Perceived Need and Use of Adolescent Mental Health Services in Korea / 신경정신의학

OBJECTIVES: This study investigated the sociodemographic characteristics and emotional and behavioral factors associated with the perceived need and use of adolescent mental health services in Korea. METHODS: We assessed 1857 middle school students (aged 14-16 years) in the city of Osan, Korea. We administered a self-reported questionnaire, which included sociodemographic data, Youth Self Report (K-YSR), and perceived need and use of mental health services. Multiple regression analyses were performed for identification of predictable sociodemographic characteristics, as well as the emotional and behavioral factors of the perceived need and use of adolescent mental health services. RESULTS: Overall, 11.6% of the adolescents demonstrated a perceived need for mental health services regarding their emotional or behavioral problems, while 2.1% used mental health services. Discrepancies were observed between the perceived need and use. Most adolescents (81.6%) used mental health services without self-perceived need, and only 3.3% of adolescents with self-perceived need utilized mental health services. The perceived need for mental health services is positively influenced by the adolescent's anxious/depressed and attention problems. Use of them is negatively influenced by the adolescent's withdrawn problems. CONCLUSION: Although the perceived need for mental health services is high, only a small proportion of adolescents receive them. There is a discrepancy between the perceived need and use and the factors associated with them are different. In order to increase the actual use of mental health services, it is necessary to concern their internalizing problems, such as anxious/depressed and withdrawn, in addition to externalizing problems.

Relationship Between Anxiety and Stroke Warning Signs in the Elderly

OBJECTIVES: We aimed to investigate the relationship between anxiety and stroke warning signs in the elderly. METHODS: Data obtained from 1,078 subjects (256 men and 822 women) aged above 65 years was analyzed from Suwon Project, which was a cohort comprising of nonrandom convenience samples. All the subjects completed the study questionnaire including their demographic characteristics, history of current and past illnesses, drug history, Korean version-Mini Mental State Examination (K-MMSE), SGDS-K (Korean version of the Geriatric Depression Scale-Short Form), BAI (Beck Anxiety Inventory). Stroke warning signs were defined as 5 stroke warning signs consistent with the American heart association public health message. RESULTS: There was significant relationship of anxiety and the number of stroke warning signs after adjusting age, sex, educational level and depression (beta=2.145, p<0.0001). On analysis of covariance, the interaction of the number of experienced stroke warning signs with sex on anxiety was observed after adjusting for the age, educational level, K-MMSE, and SGDS-K (p=0.011). CONCLUSION: These results suggest that there was significant relationship of anxiety and stroke the elderly.

Both R(-)- and S(+)-Citalopram Attenuate Neuronal Apoptosis in Murine Cortical Cell Culture / 대한정신약물학회지

OBJECTIVE: Several lines of evidence have shown that neuronal injury might represent a possible pathway to mood disorders. The present study was performed to examine the possibility that the neuroprotective effects of R(-)- and S(+)-citalopram depend on types of neuronal cell death. METHODS: Free radical neurotoxicity was induced in mixed cortical cell cultures by continuous exposure to 30 micrometer Fe++ for 24 hours, which produced hydroxyl radicals via a Fenton reaction. Cultures measuring excitotoxicity were exposed for 24 hours to 50 micrometer NMDA. Neuronal apoptosis was induced by 100 nM staurosporine exposure for 24 hours. Neuronal death was analyzed 24 hours later by measuring the efflux of lactate dehydrogenase (LDH) into the bathing medium or by counting viable neurons after staining with trypan blue. RESULTS: Co-treatment with R(-)-or S(+)-citalopram prevented staurosporine-induced apoptosis of cultured cortical cells, as well as activation of caspase-3. In contrast to the differences between enantiomers found in serotonin uptake inhibition and in the in vivo behavioral depression model, both enantiomers in this study showed similar protective effects on staurosporine-induced apoptosis. Mixed cortical cell cultures exhibited marked swelling of the neuronal cell bodies accompanied by widespread neuronal death during the 24 hours following exposure to 30 micrometer Fe++ or 50 micrometer NMDA that was not sensitive to either the R(-)-or S(+)-enantiomers of citalopram. CONCLUSION: These features suggest that the neuroprotective effect of citalopram depend on type of neuronal injury.

Childhood Predictors of Deliberate Self-Harm Behavior and Suicide Ideation in Korean Adolescents: A Prospective Population-Based Follow-Up Study

The aim of this study was to investigate predictors of adolescence suicidality in a longitudinal study. Additionally, the prevalence of deliberate self-harm behavior and suicide ideation at age 7 and during middle school were examined. Initial assessment data was obtained from 1998 to 2000, and a follow-up assessment was performed in 2006 when the original subjects became middle school students. The addresses and names of 1,857 subjects were located from the original data; they were 910 boys and 947 girls. The subjects were evaluated with the Korean version of the Child Behavior Checklist (K-CBCL), which was administered by the parents of the children, and by various demographic and psychosocial factors. They were reassessed using self reports on the Korea Youth Self Report (K-YSR); in particular, replies to items related to self-harm behavior and suicide ideation were recorded. A logistic regression analysis showed that the factors of gender, economic status, the overall amount of behavior problems, the tendency to internalizing and externalizing problems, somatic problems, thought problems, delinquent behavior, and aggressive behavior were independent predictors of adolescent suicide ideation and self-harm behavior. The importance of total behavior problems suggested that adolescent difficulty is a consequence of an accumulation of various risk factors. Accordingly, clinicians must consider a range of internalizing and externalizing issues, especially overall adaptation, for suicide intervention.

The Association of Alcohol Problems with Posttraumatic Stress Disorder Symptoms, Psychological Hardiness and the Ways of Coping in Firefighters / 신경정신의학

OBJECTIVES: This study investigated the association between alcohol problems and posttraumatic stress disorder (PTSD) symptoms, psychological hardiness, and coping mechanisms in firefighters. METHODS: We conducted an e-mail survey of 131 firefighters who were working at the two fire department stations in Gyeonggido, receiving replies from 96. Alcohol Use Disorder Identification Test (AUDIT), Impact of Event Scale-Revised (IES-R), Hardiness Scale, and The Ways of Coping Checklist were used to collect the data. We divided the subjects into three drinking groups per their AUDIT scores : social, problem, and abuse drinking groups and compared PTSD symptoms, psychological hardiness, and coping strategies among the groups. RESULTS: Of the 96 firefighters, 73 (76.1%), 11 (11.4%), and 12 (11.4%) belonged to the social, problem, and abuse drinking groups, respectively. Control, one component of psychological hardiness, was significantly lower in the abuse drinking group. However, IES-R scores and four subscales of the Ways of Coping Checklist did not vary significantly among the groups. CONCLUSION: These results suggest an approach focused on psychological hardiness should show a preventive effect with regard to firefighters' alcohol problems.

The present state of chid abuse in Korea and its system for child protection / 소아과

An act of children's welfare was made in 1961 for the first time in Korea but it had been nothing but the name in view of practical impact to prevention of child abuse. Real undertakings of Child Abuse Prevention were commenced overtly since 2000 in Korea, when the law for children's welfare was revised to put protective settings for the victims and to establish criterion for children's safety. The history of Child Abuse Prevention is very short in Korea but the reporting cases increased very fast from 4,133 cases in 2001 up to 9,570 cases in 2008 with the enthusiastic activities from people of the associated organizations along with the national supports. But the portion reported by the mandated reporters such as teachers or doctors is still low compared to those of the developed countries. The National Child Protection Agency (NCPA) was founded in 2001 by the Ministry of Health and Welfare to prevent child abuse and to aid recovery of abused and neglected children including their families, through the cooperation of related organizations. NCPA refers reported cases of child abuse to appropriate local centers, operates a computer database system for case management, publicizes national reports of child abuse on a yearly basis and technically supports the Local Child Protection Agency (LCPA) by developing scales for assessment of child abuse and neglect and distributing programs for the education of mandatory reporters. LCPAs operate 24-hour telephone hotline, investigate and visit homes and provide in home services networking with local resources, and operate multidisciplinary teams for screening child abuse victims and supervising case management through multimodal systems. We summarized the present state of child abuse in Korea and reviewed the operating systems for child protection in this country. Through this article, we hope that medical peoples are to be informed on the seriousness of child abuse and to be able to devote themselves for the prevention of child abuse.

The present state of chid abuse in Korea and its system for child protection / 소아과

An act of children's welfare was made in 1961 for the first time in Korea but it had been nothing but the name in view of practical impact to prevention of child abuse. Real undertakings of Child Abuse Prevention were commenced overtly since 2000 in Korea, when the law for children's welfare was revised to put protective settings for the victims and to establish criterion for children's safety. The history of Child Abuse Prevention is very short in Korea but the reporting cases increased very fast from 4,133 cases in 2001 up to 9,570 cases in 2008 with the enthusiastic activities from people of the associated organizations along with the national supports. But the portion reported by the mandated reporters such as teachers or doctors is still low compared to those of the developed countries. The National Child Protection Agency (NCPA) was founded in 2001 by the Ministry of Health and Welfare to prevent child abuse and to aid recovery of abused and neglected children including their families, through the cooperation of related organizations. NCPA refers reported cases of child abuse to appropriate local centers, operates a computer database system for case management, publicizes national reports of child abuse on a yearly basis and technically supports the Local Child Protection Agency (LCPA) by developing scales for assessment of child abuse and neglect and distributing programs for the education of mandatory reporters. LCPAs operate 24-hour telephone hotline, investigate and visit homes and provide in home services networking with local resources, and operate multidisciplinary teams for screening child abuse victims and supervising case management through multimodal systems. We summarized the present state of child abuse in Korea and reviewed the operating systems for child protection in this country. Through this article, we hope that medical peoples are to be informed on the seriousness of child abuse and to be able to devote themselves for the prevention of child abuse.

A Study of Sexual Assaults on Children and Adolescents: Based on Data from a One-Stop Service Center

OBJECTIVES: The aim of this study was to identify characteristics of children and adolescents who were victims of sexual assault in Korea. METHODS: The subjects were 60 children and adolescents who visited the one-stop center as victims of sexual assault. The medical records of victims of sexual trauma were retrospectively reviewed. We studied the demographic data of the victims, their relationship to their perpetrator, the characteristics of the assault (frequency, duration, place, type), and the process from sexual assault to treatment. We also paid special attention to how the characteristics of the victims or perpetrators affected the characteristics of the assault or follow-up treatment. RESULTS: There were several differences between sexual assaults committed by strangers and those committed by acquaintances. Sexual assaults committed by acquaintances lasted for a longer period of time than those committed by strangers. In addition, it took more time for victims of sexual assaults committed by acquaintances to seek treatment than those who were victims of sexual assaults committed by strangers. The majority (55.0%) of victims were between 10 and 15 years of age. Forty percent of the perpetrators were teenagers, and two of them were under the age of 10. Voluntary discontinuation of treatment was more frequent in adolescents than in children. CONCLUSION: All teenage victims of sexual assault need some sort of urgent intervention. In addition, approachable methods are needed in order to prevent sexual abuse by strangers or acquaintances.