Psychiatry Investigation最新文献

Objective: The study compared differences in various neurocognitive characteristics across treatment modalities among schizophrenia patients recruited in one city between July 2020 and June 2023 who were on regular medication.

Methods: Of the 151 participants, 113 were included in the analysis. Participants were divided into community-based and hospital-based groups, and their demographics and clinical characteristics, including insight, quality of life, positive and negative symptoms, and personal and social functioning, were examined. In addition, several aspects of cognition were assessed using neurocognitive assessments such as the Trail Making Test (TMT), Stroop test, and Wisconsin Card Sorting Test (WCST). After adjusting for age differences between groups, the final analysis included data from 42 participants in the community-based group and 33 participants in the hospital-based group.

Results: Hospital-based group participants completed Stroop-W more rapidly, excelled in Rey-Osterrieth Complex Figure Test recall and recognition, and incurred fewer TMT Part B (TMT-B) and Stroop-C errors. Additionally, they outperformed in WCST total, non-persistent errors, and categories completed. Contrastingly, community-based group participants showed superior outcomes in WCST persistent responses and errors, suggesting specific neurocognitive strengths.

Conclusion: We found differences in neurocognitive characteristics between the two groups. These differences were consistent across a range of cognitive domains, including attention, visual discrimination, memory, and executive functioning. Further large-scale study is needed to generalize cognitive characteristics across treatment modalities.

Objective: Suicide is a significant public health issue, with South Korea having the highest suicide rate among Organisation for Economic Cooperation and Development countries. This study aimed to develop clinical guidelines for suicide prevention in psychiatric patients in Korea using the ADAPTE methodology.

Methods: The development process involved a comprehensive review of literature, expert consultations, and consensus-building using the Nominal Group Technique and Delphi method. The guidelines focus on evidence-based psychiatric treatments, including both pharmacological and non-pharmacological approaches, tailored to the Korean context. Key findings underscoring the need for standardized treatment protocols for patients with major psychiatric disorders, including bipolar disorder, major depressive disorder, and schizophrenia.

Results: The guidelines incorporate treatments like lithium, clozapine, atypical antipsychotics, electroconvulsive therapy, and cognitive behavioral therapy, which have shown effectiveness in suicide prevention. Applicability and acceptability within Korea's healthcare system were addressed, ensuring feasibility given the country's medical insurance coverage and accessibility. The guidelines were validated through expert reviews and Delphi rounds, achieving consensus on the final recommendations.

Conclusion: The developed guidelines provide a structured, evidence-based approach to reducing suicide rates among psychiatric patients in Korea. Future research will focus on expanding these guidelines to include screening protocols for high-risk groups.

Objective: To date, the feasibility of autonomous sensory meridian response (ASMR) as a complement to traditional treatments for patients with depression remains unclear. The main objective of this study was to investigate the effects of breathing-relaxation training plus ASMR on mood and depressive symptoms in patients with mild depression.

Methods: A quasi-experimental pre- and post-test design with a non-equivalent control group was used. Forty patients with mild depression were assigned to the experimental group that received breathing-relaxation training plus ASMR or the wait-list control group for a total of 8 training sessions. To assess mood and depressive symptoms, the Korean version of the Profile of Mood State-Brief and the Patient Health Questionnaire-9 were performed.

Results: There was no significant difference in baseline demographic characteristics between both groups. After the 8 training sessions, the experimental group achieved a significantly greater improvement in mood and depressive symptoms with more ASMR experiences compared to the control group.

Conclusion: These findings illustrated the feasibility of ASMR as a complementary tool and breathing-relaxation training plus ASMR might be clinically beneficial to alleviate negative mood and depressive symptoms in patients with mild depression.

Objective: The coronavirus disease-2019 (COVID-19) pandemic has had a severe impact on mental health. To explore the underlying mechanisms that influence mental health, a critical question is whether different types of coping strategies may mediate the relationships between COVID-19 related stress and mental health.

Methods: Recruited between October 19 and 24, 2021, a total of 500 participants aged 20 to 69 years completed an online survey to evaluate the COVID-19 stress, coping orientation, depression and state anxiety. The period corresponded to the highest level of COVID-19 restrictions (level 4) immediately before the adjusted restriction to level 3. Parallel mediation analyses were conducted using structural equation modeling.

Results: Distinct mediation effects of the COVID-19 stress (i.e., fear of infection, difficulties of social distancing, anger toward others) through three types of coping strategies (i.e., functional, dysfunctional, seeking support) were found. Fear of infection was likely to be related to functional coping and dysfunctional coping. Social distancing model indicated dysfunctional coping and seeking support, while anger toward others model was associated with functional coping and seeking support.

Conclusion: The results highlight the different relationships between COVID-19 stress and mental health coping strategies. The identification of these mediation pathways offers guidance for designing effective interventions and support systems to promote psychological well-being during challenging times like the COVID-19 pandemic.

Objective: This study introduces a novel home-based dual-task platform incorporating augmented reality (AR), COGNIMO, aimed at simultaneously enhancing cognition and physical abilities. The purpose of this study was to assess the effectiveness of this intervention in enhancing cognitive and physical abilities in elderly individuals with subjective cognitive decline, mild cognitive impairment (MCI), and mild Alzheimer's dementia.

Methods: A 12-week observational study enrolled 57 participants aged 60-85 years. Primary outcomes included changes in cognitive scores (Korean Mini-Mental State Examination, 2nd edition [K-MMSE-2] and Korean-Montreal Cognitive Assessment [K-MoCA]), while secondary outcomes measured physical parameters and depression scores between baseline and week 12 in the active and the control groups.

Results: Of 57 participants, 49 completed the study. The active group (≥12 sessions) exhibited significant improvement in K-MoCA compared to the control group (<12 sessions) (p=0.004), while K-MMSE-2 score changes showed no significant difference (p=0.579). Positive correlations between training sessions and K-MoCA changes were observed (r=0.31, p=0.038), emphasizing a dose-response relationship. Subgroup analyses revealed a distinction in cognitive changes, particularly in the MCI group.

Conclusion: The COGNIMO platform showed positive effects on cognitive function in MCI patients, suggesting potential benefits for this population. The study highlights the potential of AR-integrated home-based interventions for cognitive enhancement in elderly individuals, underlining the need for further trials in the future.

Objective: Korea's transition into a super-aged society brings to the forefront the escalating dementia prevalence and the consequent rise in mortality, highlighting the need for effective end-of-life (EOL) care strategies. Despite legislative advancements, gaps remain in addressing the medical and ethical challenges of EOL care for patients with advanced dementia, particularly in evaluating treatment options like nasogastric tube (NGT) use and mechanical ventilation (MV). This study investigates the attitudes of the general population (GP) and clinicians in Korea towards EOL treatment decisions.

Methods: A cross-sectional, web-based survey was conducted among 500 members of the GP and 200 clinicians from a university hospital. Case vignettes were used to assess attitudes towards EOL treatment decisions, specifically focusing on NGT and MV use, and to explore the influencing factors.

Results: There was a notable difference in favorable attitudes toward NGT withdrawal between the GP (62.2%) and clinicians (39.0%). Otherwise, both groups showed higher acceptance of MV withholding (82.2% [GPs] and 82.5% [clinicians]) when informed of the patient's verbal intention regarding life-sustaining treatment (LST), and attitudes were more positive with written advance directives. Also, it was decreased when patient intentions were unclear.

Conclusion: The results suggested the need to consider NGT as a medical intervention requiring a risk-benefit analysis. Although LST decision-making in patients with advanced dementia is still limited in Korea, this study showed the shared recognition among the GP and clinicians of the importance of EOL treatment decisions that consider patient wishes and quality of life for patients with advanced dementia.

Objective: This study explored the negative emotional impact of peer suicide on adolescent students during the early stages of becoming aware of suicide and examined the adverse effects of related environmental and mental health factors.

Methods: This study was conducted from March 1, 2020 to December 31, 2021, targeting students enrolled in middle and high schools where student suicide occurred. Emotional impact was assessed using the Korean version of the Impact of Event Scale-Revised (IES-R-K), State-Trait Anxiety Inventory-X, Center for Epidemiologic Studies-Depression Scale (CES-D), and Beck's Scale for Suicide Ideation (SSI). χ2 test and Pearson's correlation analysis were performed to analyze subgroup differences and explore relationships between scale scores, respectively.

Results: Of the 2,382 participants, 25.1% belonged to the post-traumatic stress disorder (PTSD) or PTSD tendency group on the IES-R-K, and 22.2% showed abnormalities in the State-Trait Anxiety Inventory-State. Students in the same class as the deceased student and those in the same grade but in different classes had higher risk rates than those in different grades. Boarding school students had 1.9 times higher odds of experiencing emotional impacts than non-boarding students. On the CES-D, 10.4% of the students showed potential depression, with 3.7 times higher odds of experiencing emotional impact than those with normal scores. Moreover, 4.5% of the students reported suicidal ideation on the SSI, with those experiencing mild suicidal ideation having 1.9 times higher odds of experiencing emotional impact than those with normal scores.

Conclusion: A significant proportion of students experienced negative impacts of peer suicide. Students in close-knit environments, such as the same class, grade, and boarding school as the deceased, or those with depression or anxiety experienced a more pronounced negative impact.

Objective: The aim of this study was to investigate the association between blood levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and cognitive impairments among elderly individuals.

Methods: Peripheral concentration of TNF-α and IL-6 were measured in all subjects. To assess individual cognitive function, the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery (CERAD-NP) was used, and standardized scores (z-scores) were calculated for each test. Cytokine levels were compared between the diagnostic groups, and correlations between blood inflammatory factor levels and z-scores were analyzed.

Results: The 37 participants included 8 patients with Alzheimer's disease (AD), 15 subjects with mild cognitive impairment (MCI), and 14 cognitively healthy controls. TNF-α and IL-6 levels were higher in patients with AD than in healthy controls. TNF-α levels were higher in the AD group than in the MCI group. However, after adjusting for age, the associations between diagnosis and TNF-α and IL-6 were not significant. The higher the plasma IL-6 level, the lower the z-scores on the Boston Naming Test, Word List Learning, Word List Recognition, and Constructional Recall. The higher the serum TNF-α level, the lower the z-scores on the Word List Learning and Constructional Recall. Negative correlation between serum TNF-α level and the z-score on Word List Learning remained significant when age was adjusted.

Conclusion: The difference in the blood levels of TNF-α and IL-6 between the diagnostic groups may be associated with aging. However, elevated TNF-α levels were associated with worse immediate memory performance, even after adjusting for age.

Objective: Observational studies often report disturbed sleep patterns in individuals with diabetic nephropathy (DN). The possible causal relationship behind these connections remains unknown. This research assessed the possible cause-and-effect relationship between eleven sleep-related characteristics and the risk of developing DN using a two-sample Mendelian randomization (MR) study.

Methods: This study employed a two-sample bidirectional MR analytical approach. Genetic data for eleven sleep-related characteristics were acquired from the genome-wide association studies (GWAS) database of individuals of European ancestry which involve scanning complete sets of DNA, or genomes. GWAS summary data for DN included 4,111 DN cases and 308,539 controls. Instrumental variables were single nucleotide polymorphisms strongly linked to sleep-related characteristics. The main analysis used the random-effects inverse variance weighted (IVW) approach, with validation through sensitivity testing.

Results: MR analysis revealed that a higher genetic predisposition for sleep efficiency reduced the chance of developing DN (odds ratio [OR]: 0.384; 95% confidence interval [CI] 0.205-0.717; p=0.003). Genetic susceptibility to DN was associated with a higher likelihood of experiencing more sleep episodes (OR: 1.015; 95% CI 1.003-1.028; p=0.016). Sensitivity analysis confirmed the robustness of these correlations. No significant connections were found between other genetically predicted sleep characteristics and the likelihood of developing DN.

Conclusion: Our research indicates that a genetic predisposition for better sleep efficiency is linked to a lower risk of developing DN. There is also evidence suggesting that genetic predisposition to DN may directly impact sleep episodes. Further research is needed to explore the molecular mechanisms underlying these findings.

Objective: This study aimed to examine the relationship between domestic violence, past depressive disorder, unplanned pregnancy, suicide risk, and postpartum depression among Korean women using a mediation model approach.

Methods: A web-based, cross-sectional survey was performed from September 21 to September 30, 2022. Participants included 1,486 women in their first year postpartum from Chungnam Province, South Korea. The generalized linear model mediation was analyzed using the R-based Jamovi 2.3.21 version program.

Results: Of all participants, 8.7% had domestic violence experience, 7.5% had been diagnosed with depressive disorder by the doctor in the past, 33.0% had reported that the last pregnancy was unplanned, 39.9% had postpartum depression, and 11.2% of the participants had a suicide risk. Among the participants with a high risk of suicide, 34.4%, 37.5%, 53.1%, and 96.9% reported experiencing domestic violence, past depressive disorder, an unplanned pregnancy, and postpartum depression, respectively. Postpartum depression partially mediated the relationship between domestic violence, past depressive disorder, and suicide risk and completely mediated the relationship between unplanned pregnancy and suicide risk.

Conclusion: Our findings highlight the necessity for screening and early intervention for suicide risk and postpartum depression from pregnancy to the first year postpartum.