Psychopathology Associated with Participant Role among Bullying Situation / 신경정신의학

OBJECTIVES: In recent years, school violence has been increasing and this situation is complicated by various factors. The objective of this study is to explore the distribution of the participants' roles and to examine the psychopathology associated with these roles among middle school students. METHODS: In a cross-sectional study, 490 middle school students completed the Participant Role Questionnaire (PRQ) for classifying the participants' roles in a bullying situation. The Korean-Youth Self Report (K-YSR), Revised Children's Manifest Anxiety Scale (RCMAS), Rosenberg Self-Esteem Scale (RSE) and Parent Adolescent Communication Inventory (PACI) were also included to evaluate the psychopathology of the students. RESULTS: The distribution rates of the bully, assistant, reinforcer, defender and outsider groups were 4.1%, 3.1%, 5.3%, 53.7%, and 32.0%, respectively. Among the syndrome scales of K-YSR, almost each items' and the total scores (p=0.049), RCMAS (p=0.000), PACI (p=0.000), and RSE (p=0.000) were significantly different among all group. The average scores on the K-YSR and RCMAS were the highest in the assistant and reinforcer groups. CONCLUSION: The assistant and reinforcer groups showed more severe psychopathologies. This means that they suffered from more difficulties than the other groups. Therefore, they need more intensive therapeutic interventions. Except for the defender group, who prevented bullying, the outsider group was the largest group. Therefore, a comprehensive approach that can change outsiders to defenders should be employed for the prevention of bullying in adolescents.

Prevalence and Correlates of DSM-IV Mental Disorders in South Korean Adults: The Korean Epidemiologic Catchment Area Study 2011

OBJECTIVE: The aim of this study was to estimate the prevalence and correlates of mental disorders in Korean adults. METHODS: Door to door household surveys were conducted with community residents aged 18-74 years from July 19, 2011, to November 16, 2011 (n=6,022, response rate 78.7%). The sample was drawn from 12 catchment areas using a multistage cluster method. Each subject was assessed using the Korean version of the World Health Organization Composite International Diagnostic Interview (CIDI) based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). RESULTS: Lifetime and 12-month prevalence estimates were as follows: alcohol use disorders, 13.4% and 4.4%, respectively; nicotine use disorders, 7.2% and 4.0%, respectively; anxiety disorders, 8.7% and 6.8%, respectively; and mood disorders, 7.5% and 3.6%, respectively. The prevalence rates of all types of DSM-IV mental disorders were 27.6% and 16.0%, respectively. Being female; young; divorced, separated, or widowed; and in a low-income group were associated with mood and anxiety disorders after adjustment for various demographic variables, whereas being male and young were associated with alcohol use disorders. Higher income was not correlated with alcohol use disorder as it had been in the 2001 survey. CONCLUSION: The rate of depressive disorders has increased since 2001 (the first national survey), whereas that of anxiety disorders has been relatively stable. The prevalence of nicotine and alcohol use disorders has decreased, and the male-to-female ratio of those with this diagnosis has also decreased.

Psychopathology Associated with Cyberbullying among Middle School Students / 신경정신의학

OBJECTIVES: Cyberbullying has recently become a major concern in Korea and especially poses a serious threat to adolescents. The object of this study is to examine the psychopathology of perpetrators and victims of cyberbullying. METHODS: In a cross-sectional study, 490 middle school students completed questionnaires on bullying and victimization experiences in cyberspace. Korean-Youth Self Report (K-YSR) was included to evaluate the psychopathology of the students. RESULTS: The prevalence rates of victims and perpetrators of cyberbullying were 6.92% and 3.33%, respectively. Among 9 sub-scales of K-YSR, the scores of depressed/anxious (p=0.049), thought problems (p=0.002), and attention problems (p=0.039) were significantly different between victim, perpetrator, victim/perpetrator, and control group. Multinomial logistic regression indicated that the victim group was associated with depressed/anxious [odds ratio (OR)=1.10], social immaturity (OR=1.24), thought problems (OR=1.32), and self-destructive identity problems (OR=1.16). The perpetrator group was associated with thought problems (OR=1.37) and attention problems (OR=1.21). The victim/perpetrator group was associated with delinquent behavior (OR=2.04). CONCLUSION: Middle school students involved in cyberbullying were associated with psychopathologies including depression, anxiety, thought problems, attention problems, and delinquent behaviors. The risk of cyberbullying is escalating with the rapid advancement in technology. Therefore, a comprehensive approach should be employed for prediction and prevention of cyberbullying in adolescents.

The Association between Weight-Related Attitudes and Suicidal Ideation in Adults / 신경정신의학

OBJECTIVES: The aim of this study is to investigate the relationship between weight-related attitudes and suicidal ideation among adults. METHODS: Data were obtained from the Fifth Korean National Health and Nutrition Examination Survey, a cross-sectional national health survey. We used a nationally representative sample of 12287 Koreans older than 19 years of age (5266 men and 7021 women). We used the logistic regression model to examine the relationship between weight-related attitudes and suicidal ideation, controlling for demographics, depressive mood, perceived stress, and substance use. RESULTS: A significantly higher number of women than men reported suicidal ideation (women : 18.3%, men : 10.3%). In men, weight control behavior aimed at weight loss (vs. no control) showed an association with suicidal ideation. For women, weight control behavior aimed at maintaining a certain weight (vs. no control) and obesity (vs. being underweight), as determined by Body Mass Index category, showed an association with suicidal ideation. For both sexes, distortions regarding perceived weight did not significantly affect suicidal ideationn. CONCLUSION: The results of this study suggest that weight-related attitudes, such as weight control behaviors, are useful indicators for identification of individuals at risk of committing suicide.

Correlation between Tobacco Smoking and Mental Disorders Including Suicidal Tendencies / 신경정신의학

OBJECTIVES: In South Korea, there is limited information on nicotine dependence (ND) and its correlation with psychiatric disorders. Based on the National Epidemiologic Survey of Psychiatric Disorders in South Korea in 2006, we examined the relationship between the severity of tobacco smoking and mental disorders, paying specific attention to suicidal ideas, plans, and attempts. METHODS: A total of 6,510 adults underwent face-to-face interviews. The Korean version of the Composite International Diagnostic Interview (K-CIDI) was used to evaluate lifetime prevalence and correlates of mental disorders. According to the the severity of tobacco smoking, participants were grouped into never-smokers, ever-smokers, and ND. The frequencies of mental disorders and suicidal tendencies were analyzed among ND/ever-smokers. Multivariate logistic regression analysis was used to predict the odds ratios and significance levels among groups. RESULTS: Associations of ND with alcohol use disorder, mood disorder, anxiety disorder, pathological gambling, and suicidal tendencies were significant, even after controlling for demographic characteristics. Associations of most psychiatric disorders with smoking were stronger in females than in males. CONCLUSION: ND is highly associated with alcohol use disorder, mood and anxiety disorders, pathological gambling, and suicidal tendencies. Interventions are needed in order to prevent the development of ND from regular smoking.

Prevalence and Correlates of Major Mental Disorders among Korean Adults : A 2006 National Epidemiologic Survey / 신경정신의학

OBJECTIVES : The aims of this study are to estimate the prevalence of the DSM-IV psychiatric disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI), and to compare those with previous studies. METHODS : The Korean Epidemiologic Catchment Area study Replication (KECA-R) was conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas. A multistage, cluster sampling design was adopted. The target population included all eligible residents aged 18 to 64 years. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview (K-CIDI) based on the DSM-IV (N=6,510, response rate=81.7%). RESULTS : A total of 6,510 participants completed the interview. The lifetime and 12-month prevalence rates for all types of DSM-IV disorders were 30.0% and 17.3%, respectively. Those of specific disorders were as follows : 1) alcohol use disorder, 16.2% and 5.6% ; 2) nictotine use disorder, 9.0% and 6.0%;3) specific phobia, 3.8% and 3.4%;4) major depressive disorder, 5.6% and 2.5% ; and 5) generalized anxiety disorder, 1.6% and 0.8%. Data relating to nicotine and alcohol use disorder revealed a very high male/female ratio. Mood disorder and anxiety disorder were more prevalent among females than males. CONCLUSION : The prevalence of psychiatric disorders was high. In comparison with other studies, remarkable differences in the distribution of psychiatric disorders across the country and times were observed.

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.

Service Priority and Standard Performance of Community Mental Health Centers in South Korea: A Delphi Approach

OBJECTIVE: The role of community mental health centers (CMHCs) in Korea is quite different than that of these centers in Western countries due to nation-specific health care system characteristics. For example, CMHCs of Korea are expected to provide services for serious mental illness in addition to other services in response to community needs, such as internet addiction of adolescents. Consequently, it is important to determine service priorities of CMHCs and to define standard service performances in order to maximize their effectiveness with limited resources. The present study aimed to generate expert consensus on service priorities and to identify standard service performances of CMHCs in South Korea. METHODS: Forty-five mental health professionals participated as experts in a Delphi survey. We made a survey questionnaire based on Korean and international data and guidelines of some countries such as the UK and Australia. Experts answered the first and second round questionnaires and their answers were analyzed using frequency analysis. RESULTS: For the question about future directions of CMHCs, twenty-two experts (49%) answered that the growth of services for serious mental illness should be preferred to other areas. The service for chronic mental illness was thought to be the most important service area (27.1%) and, early psychosis (10.5%) is included, the services for serious mental illness should be regarded as the most important service area of Korean CMHCs. It is followed by child and adolescent services (13.2%) and mental health promotion services (10.8%). The relative importance of service performances on each service domain were given by answers of experts. CONCLUSION: CMHCs in Korea should focus their priority on the management of serious mental illness. Service standardization by the relative importance of service performances on each service domain is needed.

Community Psychiatry Training for Psychiatry Residents: A National Survey / 신경정신의학

OBJECTIVES: There is a increasing need to recruit and retain more psychiatrists who can plan and implement organized programs to work with chronic mentally ill patients in community settings. The aim of study is to discover what training is currently in place to prepare psychiatrist for work in "community" or "public" settings. METHODS: Survey questionnaires were mailed to 85 residency training directors and 10 leaders of community mental health in 2005. Response rate was 75%. RESULTS: Academic seminar about community mental health were not administered to residents in 63% of training hospitals. Forty one out of 64 training hospitals had community mental health rotation programs. Community mental health center (50%) and day hospital (36%) were the most common type of programs. Few general hospital had affiliation with community mental health programs. The amount of time for clinical rotation varied from less than three months part time to 6 months fulltime, with most frequent form of one day per week for three month in second or third year of psychiatry residents. CONCLUSION: Further steps are needed to improve residency training curricula and to encourage well qualified psychiatrist to choose careers in community psychiatry.

Sociodemographic Characteristics and Emotional and Behavioral Problems Related with Internet Addiction Tendency in Adolescents / 신경정신의학

OBJECTIVES: The objective of this study is to investigate the relations of internet addiction to sociodemographic characteristics and emotional and behavioral problems of adolescents in Korea. METHODS: We assessed 1432 middle school students in the city of Osan, Korea. We administered a self-reported questionnaire including sociodemographic data, Korean versions of Internet Addiction Scale (K-IAS) and Youth Self Report (K-YSR). All the students were divided into 3 groups (internet addiction group, overuser group and normal control group) according to the scores of K-IAS. Chi-square and one-way ANOVA were used to compare the 3 groups. After the correlations among each sociodemographic characteristics and emotional and behavioral problems were performed, the multiple regression analysis was conducted to identify the predictable factors of internet addiction tendency. RESULTS: There were significant differences among 3 groups in the gender, age, cigarette smoking, alcohol use and the age of initial internet use. The addiction group (K-IAS> or =70, N=32) had significantly higher rate of males, older students, cigarette smoking, alcohol use and earlier starting age of internet use than the control group (K-IAS<40, N=881). And the mean scores of all scales except somatic complaints subscale of K-YSR showed in the order of addiction group, overuser group, than control group. In the somatic complaints subscale, addiction group had significantly higher mean scores than other 2 groups but there was no difference between overuser group and control group. Multiple regression analysis showed that attention problems, male, delinquent behavior, aggressive behavior, withdrawn and the age of initial internet use could explain 29.6% of internet addiction tendency. CONCLUSION: These results suggested that the earlier familial education and environmental intervention of internet use would be helpful to prevent internet addiction. Attention problems, male and delinquent behavior, aggressive behavior and withdrawn were predictable factors of internet addiction, and this is well compatible with more male prevalence in ADHD and disruptive behavior disorders. This suggested that the intervention focused on the gender difference to prevent and treat internet addiction could be effective.

Mental Health Policy in Korean Neuropsychiatric Association / 신경정신의학

Recently Our medical systems have been changed to a great extent and mental health systems have evolved as well ; with increased mental disorders, suicide, family violence, and increasing an elderly population. Currently, the general population has become more aware of an importance of mental health, and increasing mental disorders in turn led to massive social burdens. This requires an emergence of new national mental health policy. By establishing the national mental health policy, we, Korean Neuropsychiatric Association, are able to build a reputation that we deserve as a professional group, and provide the mental health promotion of the general population and improve the quality of life of those that are mentally ill.

Four Years Reviewer Evaluation Reports of "Journal of Korean Neuropsychiatric Association" / 신경정신의학

Four Years Reports of "Journal of Korean Neuropsychiatric Association" during 2001 to 2005 were evaluated by 18 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation processes, "Journal of Korean Neuropsychiatric Association" will develop a good journal.

Four Years Reviewer Evaluation Reports of "Journal of Korean Neuropsychiatric Association" / 신경정신의학

Four Years Reports of "Journal of Korean Neuropsychiatric Association" during 2001 to 2005 were evaluated by 18 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation processes, "Journal of Korean Neuropsychiatric Association" will develop a good journal.

Two Years Reviewer Evaluation Reports of "Journal of Korean Neuropychiatric Association" / 신경정신의학

Two Years Reports of "Journal of Korean Neuropychiatric Association" during 2001 to 2003 were evaluated by 17 Editorial Board of Korean Neuropsychiatric Association. We investigated the articles to specific fields and rejection rate etc. by different section chiefs. Although several problems concerning review time duration and rejection guideline issues indicated but generally all reviewer processes proved relatively clear and concise criteria. Through these objective and systematic evaluation processes, "Journal of Korean Neuropychiatric Association" will develope a good journal.

Influencing Factors on Length of Stay of Psychiatric Patients in Mental Health-related Facilities / 신경정신의학

OBJECTIVES: The objective of this study was to explore the explanatory factors on the length of stay of psychiatric patients in various mental health-related facilities. METHODS: Subjects in this study were consisted of 1,028 psychiatric patients staying in 22 mental health-related facilities randomly sampled after proportional stratification by regions. The subjects in 22 mental health-related facilities including psychiatric hospitals/clinics, psychiatric welfare facilities, welfare facilities for homeless, and illegal institutions were interviewed by psychiatrists and social workers with clinical experience. Demographic characteristics, socioeconomic support, diagnosis/history of illness, clinical symptom/functional disability and type of facilities were investigated and included in the multiple regression models to examine their influence on the length of stay. RESULTS: Two thirds of total variance of length of stay were explained by the independent variables in this study, and the type of facilities had the most explanatory power. In addition to type of facilities, sex, age, economic status, type of medical security, familial support, living condition before admission, diagnosis, dual diagnosis, age of onset of illness and number of admissions were significant explanatory factors. CONCLUSION: This study provides bases for specific strategies to develop efficient mental health facilities and community mental health system by disclosing the important explanatory factors for length of stay.

A Survey for Community Attitudes toward The Mentally-Ill in Ansan Area / 신경정신의학

We investigated the range of knowledge about mental health and the attitude toward mentally-ill community residents and the results of the investigation were taken as a foundation of the program of a community mental health project. The results were as follows: 1) The residents of Ansan community showed sympathetic and positive attitude toward the community mental health ideology. 2) The opinion leaders and females had more authoritative and negative tendency to the mentally-ill. 3) The more aged the more negative, conservative, and socially restrictive attitudes were shown toward the mentally-ill. 4) The home-owners had sympathetic attitude toward the mental illness but opposed the establishment of mental health facilities in their community with behavioral reaction. Therefore, the community education about mental health should be actively and intensively concentrated upon the females, the people of old age, the opinion leaders and the home-owners.

Measurement and Determinants of Mental Health States for the Urban Poor / 신경정신의학

OBJECTIVE: This study was performed to support and enhance the community mental health for the urban poor. The purposes of the study were as follows: 1) to investigate the mental health states of the urban poor, who are the first target population, 2) to identify the factors influencing their mental health states. METHODS: The subjects were community residents in low socioeconomic level, who are 20-59 years old. And the scale used was GHQ (General Health Questionnaire) which is used for screening the mental health states of groups and self-esteem. The survey subjects were directly interviewed by staffs in Public Mental Health Center. SPSS PC 6.0 was used for the statistical analysis. It investigated the mental health states, according to social and demographic attributes, and self-esteem of target population. And the mental health states were analyzed to three subdomains: overall mental health states, social dysfunction, and anxiety-depression domains. RESULTS: First, in demographic attributes, the old men, who are of low socioeconomic level, single, bad physical health, low community life satisfaction, low educational background, and having no religons, were low in overall mental health states, social function, and high in anxiety-depression domain. Second, the residents, who had high self-esteem, were high in overall mental health states, social funtion, and low in anxiety-depression domain. Third, the residents, who had high self-esteem scores, were significantly high in overall mental health states, social function, and low in anxiety-depression domain. Fourth, Among the various factors influencing the mental health states, the self-esteem was the most important factor, and the physical health was the next important factor. And the higher self-esteem they had, the better physical health states, the older they were, the higher the mental health states became. Fifth, comparing the high risk group with non-risk group, those who were in their 20's and 40's, had no wives or husbands, low educational background, physical workers, and were not well healthy, were apt to have mental diseases. CONCLUSION: In the future, the first target population in the community mental health services will be the urban poor in low mental health states. For those who are apt to have mental diseases, the first step of community mental health works is to find, select and give basic mental health services. The staffs in community mental health center have to develop various mental health programs and inform the public of them.

An Analysis for Appropriate Psychiatric Hospitalization in Korea / 신경정신의학

OBJECTIVES: We tried to judge appropriate psychiatric hospitalization in Korea. Mental health policy necessitates the evaluation and discussion of the appropirteness for psychiatric hospitalization. This consideration will be the important index for mental helath in Korea. METHOD: We selected samples by probability proportional to size(PPS) And we used Appropriateness Evaluation Scale(AES)developed by us. Criteria asessment and clinical assessment were done by mental health professionals and psychiatrists. Overall assessment followed our flow chart. Data were analyzed with SAS(Statistical Analysis System)using Chi-square test. RESULTS: In the overall assessment, the rate of appropriate psychiatric hospitalization was 45.1%. The most contributing factors to appropriate psychiatric hospitalization were the kind of institutions, age, sex, the classification of diseases in descending order. CONCLUSION: We think that the results of this studies for appropriate psychiatric hospitalization will be followed by next other research and also the inappropriate psychiatric hospitalization will be scrutinized further.

Length of Stay in the Mental Health Facilities in Korea / 신경정신의학

We have randomly selected 1,200 psychiatric inpatients from the whole psychiatic inpatients population in Korea, and analyzed their length of stay far the purpose of contributing to community mental health practice in Korea. The results were as follows: 1) The half of total samples' length of stay were within 761 days, and 75% of them wihin 2, 613 days. 2) As for length of stay P50, asylums showed the length of stay within 2,303 days for the half of selected samples: 483 days for private mental hospitals and they showed very long-term hospitalization compared to university hospital(20 days), general hospitals(41 days), private psychiatric clinics(45 days) and national mental hospitals(83 days). 3) As for length of stay according to age distributions, the older the patients were, length of stay showed the longer. 4) Among the length of stay at P50 according to diagnoses, mental retarded patients were the longest hospitalization group in private hospitals(707 days) and small psychitric inpatient units(below 30 beds, 166 days). But schizophrenics were the longest hospitalization group(2, 560 days) at asylums. 5) Length of stay at P50 according to medical security had great differences between the medical aid group and medical insurance group, especially in asylum(2,461 days vs. 1,715 days) and mental hospitals(615 days vs. 271 days). From the above results, the authors propose that for diminishing the length of stay policy, Korean mental health system should develop new rehabilitation programs for acute symptom relieved schizophrenic patients. In addition, the treatment for the younger mentally-ill patients should be more active and intensive.

Method of Community Mental Health

No abstract available.