The characteristics of elderly suicidal attempters in the emergency department in Korea: a retrospective study.

BACKGROUND: Although Korea ranks first in the suicide rate of elderly individuals, there is limited research on those who attempt suicide, with preventive measures largely based on population-based studies. We compared the demographic and clinical characteristics of elderly individuals who attempted suicide with those of younger adults who visited the emergency department after suicide attempts and identified the factors associated with lethality in the former group. METHODS: Individuals who visited the emergency department after a suicide attempt from April 1, 2017, to January 31, 2020, were included. Participants were classified into two groups according to age (elderly, ≥65 years; adult, 18-64 years). Among the 779 adult patients, 123 were elderly. We conducted a chi-square test to compare the demographic and clinical features between these groups and a logistic regression analysis to identify the risk factors for lethality in the elderly group. RESULTS: Most elderly participants were men, with no prior psychiatric history or suicide attempts, and had a higher prevalence of underlying medical conditions and attributed their attempts to physical illnesses. Being sober and planning suicide occurred more frequently in this group. In the elderly group, factors that increased the mortality rate were biological male sex (p<0.05), being accompanied by family members (p<0.05), and poisoning as a suicide method (p<0.01). CONCLUSION: Suicide attempts in elderly individuals have different characteristics from those in younger adults and are associated with physical illness. Suicides in the former group are unpredictable, deliberate, and fatal. Therefore, tailored prevention and intervention strategies addressing the characteristics of those who are elderly and attempt suicide are required.

Fine-Grained Motion Recognition in At-Home Fitness Monitoring with Smartwatch: A Comparative Analysis of Explainable Deep Neural Networks.

The squat is a multi-joint exercise widely used for everyday at-home fitness. Focusing on the fine-grained classification of squat motions, we propose a smartwatch-based wearable system that can recognize subtle motion differences. For data collection, 52 participants were asked to perform one correct squat and five incorrect squats with three different arm postures (straight arm, crossed arm, and hands on waist). We utilized deep neural network-based models and adopted a conventional machine learning method (random forest) as a baseline. Experimental results revealed that the bidirectional GRU/LSTMs with an attention mechanism and the arm posture of hands on waist achieved the best test accuracy (F1-score) of 0.854 (0.856). High-dimensional embeddings in the latent space learned by attention-based models exhibit more clustered distributions than those by other DNN models, indicating that attention-based models learned features from the complex multivariate time-series motion signals more efficiently. To understand the underlying decision-making process of the machine-learning system, we analyzed the result of attention-based RNN models. The bidirectional GRU/LSTMs show a consistent pattern of attention for defined squat classes, but these models weigh the attention to the different kinematic events of the squat motion (e.g., descending and ascending). However, there was no significant difference found in classification performance.

Psychiatric understanding and treatment of patients with amputations.

Amputation changes the lives of patients and their families. Consequently, the patient must adapt to altered body function and image. During this adaptation process, psychological problems, such as depression, anxiety, and posttraumatic stress disorder, can occur. The psychological difficulties of patients with amputation are often accepted as normal responses that are often poorly recognized by patients, family members, and their primary physicians. Psychological problems can interfere with rehabilitation and cause additional psychosocial problems. Therefore, their early detection and treatment are important. A multidisciplinary team approach, including mental health professionals, is ideal for comprehensive and biopsychosocial management. Mental health professionals could help patients set realistic goals and use adaptive coping styles. Psychiatric approaches should consider the physical, cognitive, psychological, social, and spiritual functions and social support systems before and after amputation. The abilities and limitations of physical, cognitive, psychological, and social functions should also be considered. To improve the patient's adaptation, psychological interventions such as short-term psychotherapy, cognitive behavioral therapy, mindfulness meditation, biofeedback, and group psychotherapy can be helpful.

The psychological impact of the coronavirus disease pandemic on hospital workers in Daegu, South Korea.

OBJECTIVE: This study aimed to assess the immediate stress and psychological impact experienced by healthcare workers and other personnel during the Coronavirus disease (COVID-19) pandemic. METHOD: The sample consisted of 2554 hospital workers (i.e., physicians, nurses, allied health professionals, and auxiliary staff members) who were working in Yeungnam University Hospital in Daegu, South Korea. The Impact of Event Scale-Revised (IES-R) was administered to the hospital workers twice over a 2 week interval. A high-risk group, identified on the basic of first total IES-R, was assessed further with the Mini International Neuropsychiatric Interview (MINI) and the Clinical Global Impressions-Severity (CGIS) scale and was offered periodic psychiatric consultations on a telephone. RESULTS: The participating nurses and auxiliary staff members had significantly higher IES-R scores (p < 0.01) than the physicians. During the second evaluation, the IES-R scores of the high-risk participants had decreased by 13.67 ± 16.15 points (p < 0.01), and their CGI-S scores had decreased by 1.00 ± 0.74 points (p < 0.01). The psychological symptoms of the high-risk group who received telephone-based psychiatric consultation showed improvement after 2 weeks. CONCLUSIONS: The present findings suggest that hospital workers experience high levels of emotional stress during a pandemic. In particular, the present findings underscore the need to provide more information and support to nurses and other administrative workers. There is a need for greater awareness about the importance of mental health care among hospital workers, and rapid and ongoing psychiatric interventions should be provided to workers during the pandemic period.

Characteristics of Individuals Who Converted to Dementia during a 5-Year Follow-Up.

INTRODUCTION: Early diagnosis of dementia is important; however, the diagnostic criteria for the preclinical stage of dementia, including biomarkers and pathophysiological markers, are not suitable for application in patients in real-world clinical settings. One potential noninvasive method to predict the risk of dementia conversion is the neuropsychological test. Therefore, in this study, we examined the results of various assessments, such as comprehensive neuropsychological tests, and the daily function of participants who were evaluated periodically for 5 years. METHODS: All participants were outpatients or inpatients with subjective cognitive complaints, who visited a local university hospital for neuropsychiatric evaluation, between January 2011 and January 2019. Of a total of 1,652 subjects who underwent initial screening during this period, 107 were nondemented individuals. These participants underwent periodic comprehensive cognitive tests for up to 5 years. Survival and factors affecting dementia conversion were analyzed using the time-dependent Cox regression analysis. Assessment items included demographic information, including age, sex, and education; 5 cognitive domains of a comprehensive neuropsychological test including memory, language, attention, visuospatial functions, and frontal (executive) function; Barthel's activities of daily living; the mini-mental state examination findings; and clinical dementia rating (CDR) scores. RESULTS: This study included 61 participants (21 women and 40 men) who developed dementia during the study period. Verification of the cognitive variables affecting dementia conversion revealed that better memory was associated with a lower risk of conversion (hazard ratio [HR] = 0.614, p = 0.005) and higher attention was associated with a higher risk of conversion (HR = 1.602, p = 0.023). In the analysis of the subscales of the CDR, a higher community affairs score (i.e., less social activities) was associated with a higher risk of conversion (HR = 10.814, p = 0.028). CONCLUSION: Individuals with prominent memory decline or problems with social activities should be carefully observed for dementia conversion. Cognitive intervention techniques for cognitive stimulation, such as social and leisure activities, as well as cognitive training need to be actively used for patients in whom dementia is a concern.

Spectral Analysis of Polysomnography in Narcolepsy.

OBJECTIVE: This study was conducted to identify differences between people with narcolepsy and the normal control of delta and theta activity using electroencephalogram (EEG) spectrum analysis of nocturnal polysomnography (PSG). METHODS: Seven narcolepsy patients and seven age-sex matched normal controls underwent PSG and multiple sleep latency tests. Participants' non-rapid eye movement (NREM) sleep EEGs in PSG was analyzed using a Fast Fourier Transform technique. RESULTS: While NREM delta activity of people with narcolepsy declined during the first three periods of NREM, there was no change during the 4th period of NREM. The increase in NREM theta activity also lasted until the 3rd period of NREM but did not occur during the 4th period of NREM. In comparing sleep parameters, REM sleep latency in the narcolepsy group was significantly shorter than in controls. CONCLUSION: These results suggest that people with narcolepsy are likely to have a delta and theta activity-related sleep disturbance mechanism in NREM sleep.