Psychiatry Investigation最新文献

Objective: This study investigated the relationships among childhood trauma, somatization, depressive rumination, cognitive reappraisal, and expressive suppression among a clinical sample through a mediation model approach.

Methods: Outpatients (n=125) with a diagnosis of depression and/or anxiety were included in our study. Childhood trauma, somatization, depressive rumination, cognitive reappraisal, and expressive suppression were assessed by the Childhood Trauma Questionnaire (CTQ), Symptom Checklist-90-Revision (SCL-90-R), Korean-Ruminative Response Scale (K-RRS), and Emotion Regulation Questionnaire (ERQ), respectively.

Results: Childhood trauma was associated with somatization symptoms mediated by depressive rumination and cognitive reappraisal. In particular, emotional abuse was positively associated with somatization mediated by a depressive rumination. However, the mediating effect of expressive suppression on the relationship between childhood trauma and somatization was not significant.

Conclusion: These findings suggest that depressive rumination is a key element affecting somatization symptoms in clinical patients who experienced emotional abuse.

Objective: Depression could be related to immune function among cancer patients. The serotonin transporter gene has been reported for its associations with both depression and immune regulation. This study investigates the interaction between depression, immunity, and 5-HT transporter gene-linked polymorphism (5-HTTLPR) among colorectal cancer (CRC) patients undergoing chemotherapy.

Methods: This prospective longitudinal study collected information on depression and lymphocyte percentages at two time points: the first cycle and the final cycles of 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) chemotherapy. Clinical depression was assessed using the Hospital Anxiety and Depression Scale-depression subscale (HADS-D) score. Genotyping identified 5-HTTLPR alleles. The dependent variables were changes in the percentages of CD4+, CD8+, CD19+, and CD16/56+ lymphocytes between the two time points. Moderated regression analysis was used to find interactions.

Results: Among 104 patients, no significant direct associations were observed between changes in lymphocyte percentages and HADS-D scores. However, with the interaction of 5-HTTLPR polymorphism, the moderated regression analysis revealed two significant associations between HADS-D scores and changes in the percentages of CD4+ and CD16/56+ lymphocytes. Specifically, the percentage of CD4+ cells decreased, and the percentage of CD16/56+ cells increased, in relation to the s allele as depression worsened. These findings were consistent in a sensitivity analysis.

Conclusion: Changes in the percentage of CD4+ cells and CD16/56+ cells under depression were moderated by 5-HTTLPR alleles among CRC patients undergoing FOLFOX chemotherapy, suggesting a gene-environment interaction. Further research on the role of 5-HTTLPR in the immune system under depression among CRC patients is warranted.

Objective: Although occupational stress is a major risk factor for high anxiety in employees, the specific mechanisms underlying this relationship are not sufficiently established. This study investigated an interpersonal model of anxiety development in employees, wherein occupational stress is associated with burnout and burnout affects risk for anxiety, and examined whether this mediation is moderated by grit.

Methods: The 11,421 participants, aged 19-65 years, were employees of 18 private companies and local government organizations in South Korea. They completed the Korean versions of the Occupational Stress Scale, Oldenburg Burnout Inventory, Clinically Useful Anxiety Outcome Scale, and Grit Scale. Mediation and moderation analyses were performed using the SPSS PROCESS macro.

Results: The association between occupational stress and anxiety is mediated only by exhaustion (b=0.348, 95% confidence interval [0.330, 0.367]), not by disengagement. Moreover, the effect of exhaustion on anxiety is moderated by grit, with the effect being stronger for employees with low grit (passion: b=1.245, p<0.001; perseverance: b=1.274, p<0.001) than for those with high grit (passion: b=0.797, p<0.001; perseverance: b=1.004, p<0.001).

Conclusion: The study findings contribute to the understanding of how occupational stress is associated with anxiety in workplace, and have practical implications for preventing burnout and nurturing grit to protect employees' mental health.

Objective: Depression impairs workplace productivity. Although obesity is associated with depression, findings differ across populations. Perceived control over stressors is an important psychological factor affecting both depression and weight regulation. This study investigated whether body mass index (BMI) mediates the relationship between perceived control and depressive symptoms, considering gender differences.

Methods: A total of 7,067 Korean employees (4,627 male and 2,440 female), aged 19-65, completed self-report measures: the Perceived Stress Scale (control subscale), the CES-D scale for depressive symptoms, and self-reported height and weight, which were used to calculate BMI. Gender-stratified mediation analyses were conducted using the PROCESS macro in SPSS.

Results: Among male, lower perceived control was significantly associated with higher BMI (B=-0.099, standard error [SE]=0.031, p= 0.001), and higher BMI predicted more severe depressive symptoms (B=0.105, SE=0.035, p=0.003). The indirect effect was significant (B=-0.010, 95% confidence interval [CI] [-0.021, -0.003]), indicating partial mediation. In female, perceived control was directly associated with depressive symptoms, but BMI did not mediate this relationship (indirect effect: B=-0.004, 95% CI [-0.017, 0.004]).

Conclusion: BMI partially mediated the association between perceived control and depression in male but not in female. Perceived control was negatively associated with both BMI and depressive symptoms in both genders; however, BMI contributed to depressive symptoms only in male. Gender-specific approaches may be warranted in workplace mental health interventions.

Objective: Research specifically targeting suicidal ideation (SI) in middle-aged populations remains limited. This study aimed to predict future and concurrent SI in middle-aged Korean adults by applying four machine learning (ML) models to a nationally representative longitudinal dataset.

Methods: We analyzed data from 8,992 individuals aged 40-64 years who participated in the Korea Welfare Panel Study from the 7th (2011) to the 18th (2022) waves. Four ML algorithms were employed to develop the predictive models. The SHapley Additive exPlanations method was applied to enhance explainability.

Results: Approximately half of the participants' mean age was 49.3±8.2 years (range, 40-64 years) and 52.2% were male. The average annual SI rate between 2011 and 2022 was 2.8%±1.2%. Predictive performance for future SI was satisfactory, with area under the receiver operating characteristic curve (AUC) values of up to 0.806 (logistic regression, LR). Predictions for concurrent SI demonstrated AUC values of up to 0.907 (LR). Key predictors of future SI included subjective health status, satisfaction with family and spousal relationships, housing environment, and educational attainment. Concurrent SI was strongly associated with immediate stressors such as family violence and income dissatisfaction.

Conclusion: The ML models demonstrated good-to-excellent predictive performance for SI. These findings emphasize the importance of health, family, and socioeconomic factors, alongside mental health indicators in the prevention of SI among middle-aged adults. Building on these findings, tailored intervention strategies that comprehensively address multidimensional risk factors are essential for effective SI prevention.

Objective: This study evaluated the effectiveness of a humanities-based cognitive behavioral therapy (CBT) program for adolescents aged 11-15 years exhibiting symptoms of problematic gaming, focusing on its impact on depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), and Internet gaming disorder (IGD).

Methods: Elementary and middle school students with IGD symptoms were recruited and divided into a humanities-based CBT group (20 students) and a control group receiving supportive therapy (21 students). Participants' IGD symptoms and levels of depression, anxiety, and ADHD before and after the intervention were compared and evaluated.

Results: Verifying the effectiveness of the developed humanities treatment program showed a significant decrease in clinical scale scores indicating anxiety, ADHD, and IGD. In particular, the differences in IGD and anxiety scores between the intervention and control groups were significant, demonstrating the effectiveness of the humanities-based CBT program. Positive correlations were found between the pre-post scores for depression and IGD and between anxiety, depression, and IGD following the humanities-based intervention.

Conclusion: In this study, experts in various fields developed a humanities-based CBT program for adolescents with problematic gaming behavior and verified its effectiveness, demonstrating that programs utilizing the humanities and writing can positively affect symptoms of IGD, anxiety, depression, and ADHD in adolescents. These findings indicate the need to verify the effectiveness of humanities-based therapy programs for adolescents in more diverse regions and age groups.

Objective: Suicide is a leading cause of death among adolescents, and despite the need to distinguish between suicidal consideration and suicide attempts, research focused on suicide attempts remains insufficient. Therefore, this study aims to investigate the influence of self-perceived weight on suicide attempts.

Methods: This study utilized data from the Korea Youth Risk Behavior Web-based Survey for its analysis from 2005 to 2023, including a total of 1,156,728 participants. This study utilized various analytical methods to examine the influence of self-perceived weight on suicide attempts. We estimated weighted prevalence and used linear regression to assess temporal trend β coefficients and their differences (βdiff) with 95% confidence intervals (CIs), and survey-weighted logistic regression to estimate weighted odds ratios (wORs) and 95% CIs for the association between self-perceived weight and suicide attempts.

Results: A comparison of suicide attempts based on self-perceived weight suggested that individuals who perceived themselves as overweight (weighted prevalence, 3.97% [95% CI, 3.89 to 4.04]) had the highest rate of suicide attempts, followed by those who perceived themselves as underweight (3.36% [95% CI, 3.28 to 3.44]), while those who perceived themselves as having a normal weight (3.20% [95% CI, 3.14 to 3.27]) had the lowest rate. Additionally, females (underweight: 4.47% [95% CI, 4.32 to 4.62]; normal weight: 3.91% [95% CI, 3.81 to 4.01]; overweight: 5.23% [5.11 to 5.35]) experienced more suicide attempts than males (underweight: 2.73% [95% CI, 2.65 to 2.82]; normal weight: 2.43% [95% CI, 2.35 to 2.51]; overweight: 2.60% [95% CI, 2.52 to 2.69]).

Conclusion: Findings from the present study suggest that self-perceived weight was associated with suicide attempts and interaction analyses indicated a potential sex-based difference in the impact of body image distortion. Therefore, this study suggests the introduction of programs and campaigns aimed at correcting distorted self-perceived weight.

Objective: Recognizing discrimination as a significant public health risk during the coronavirus disease 2019 (COVID-19) pandemic, which coincided with increased drug use and heightened awareness of structural disparities in the United States, we investigated its association with the odds of drug use in a large and diverse cohort from the All of Us Research Program.

Methods: In this cross-sectional study, data from 68,976 participants completed the COVID-19 participant experiences (COPE) survey. We applied logistic regression models with propensity score-based overlap weighting to examine associations between everyday discrimination and drug use. Self-reported everyday discrimination score and drug use were the primary exposure and outcome measures, respectively.

Results: Of the 67,662 COPE respondents (mean [standard deviation] age, 57.5 [15.9] years; female sex at birth, 43,658 [64.5%]), we identified 15,493 participants with no reported discrimination and 15,493 participants with reported discrimination, after overlap weighting. The odds of drug use in those who reported discrimination was 1.38 (95% confidence interval, 1.32-1.43), with a dose-dependent association based on discrimination score. Participants who experienced discrimination had significantly higher odds of using drugs and this association was particularly pronounced in those under 40 years of age, those assigned female sex at birth, current smokers, individuals undergoing chemotherapy or immunotherapy, and those experiencing unemployment or COVID-19/flu-like symptoms.

Conclusion: This relationship was observed across various types of drugs and different reasons for discrimination, and it was particularly pronounced in specific subgroups. These findings provide critical evidence for developing targeted preventive interventions; however, further longitudinal studies for causality are warranted.

Objective: Despite the suspected link between carpal tunnel syndrome (CTS)-a common neuropathy-and psychiatric issues, long-term evidence, especially in Asia, remains scarce. This study investigated the long-term incidence of depression, anxiety, somatoform, and sleep disorders after CTS diagnosis in a South Korean nationwide cohort.

Methods: Using the Korean National Health Insurance Service cohort (2002-2013), newly diagnosed CTS patients (2004-2013) were identified following a 2-year washout period. Each CTS patient was propensity score-matched 1:10 with non-CTS controls based on demographics and health status. Cox proportional hazards regression yielded adjusted hazard ratios (aHRs) for incident depressive, anxiety, somatoform, and sleep disorders over up to 10 years of follow-up.

Results: Compared to controls, CTS patients had significantly elevated risks for all outcomes: depressive disorders (aHR, 1.59; 95% confidence interval [CI], 1.45-1.74), anxiety disorders (aHR, 1.41; 95% CI, 1.31-1.52), somatoform disorders (aHR, 1.38; 95% CI, 1.23-1.55), and sleep disorders (aHR, 1.36; 95% CI, 1.25-1.49). Risk was notably higher in individuals aged <60 years for all disorders. Males showed higher risks for depression, anxiety, and sleep disorders, while females had a slightly higher risk for somatoform disorders.

Conclusion: This comprehensive, longitudinal study indicated that CTS is associated with an increased long-term risk of psychiatric disorders. The findings emphasize comprehensive management strategies that integrate mental health screening and interventions tailored to age and sex among patients with CTS.