Psychiatry Investigation最新文献

Objective: North Korean refugees (NKRs) face substantial mental health challenges related to trauma during escape and resettlement, yet neurobiological research in this population is scarce. We examined resting-state functional connectivity (RSFC) differences between NKRs and South Korean healthy controls (SKCs) and explored associations between psychiatric symptoms and functional connectivity (FC).

Methods: Twenty-eight NKRs and 28 matched SKCs underwent functional magnetic resonance imaging and were assessed for posttraumatic stress disorder (PTSD), depression, and anxiety. Seed-to-voxel FC analysis was performed using the CONN toolbox with previously reported depression- and anxiety-related brain regions as seeds.

Results: Among the 28 NKRs, 22 had psychiatric diagnoses, including major depressive disorder and PTSD, and 18 had trauma exposure. NKRs showed significant RSFC alterations, such as lower FC between the right amygdala and visual cortex and between the left dorsolateral prefrontal cortex and postcentral gyrus, and higher FC between the left ventromedial prefrontal cortex and the bilateral putamen and between the right dorsal anterior cingulate cortex and insula. The FC between the right amygdala and visual cortex was negatively correlated with PTSD symptom severity (r=-0.427, p=0.030), and the FC between the right ventral striatum and left cerebellum was negatively correlated with trait anxiety scores (r=-0.416, p=0.035) among the NKRs.

Conclusion: Our study revealed distinct RSFC changes in NKRs compared with SKCs. These may implicate disturbances in emotional processing, cognitive control over somatosensory processing, reward processing, and heightened anxiety-related attention and adaptive stress responses among NKRs.

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: The purpose of the present study was to examine the clinical features and medication adherence of the patients diagnosed with attention deficit/hyperactivity disorder (ADHD) in their adulthood.

Methods: The present study involved a retrospective chart review of the adults who were diagnosed with ADHD during the period of March 2016 to February 2021 at a university-based, tertiary hospital in South Korea. Two-year follow-up medical records of the participants after they were diagnosed with ADHD were reviewed.

Results: The eligible sample consisted of 174 adults with ADHD (mean age, 25.14±7.84; male, 73.6%). Only 56.3% the subjects had sought treatment because of their ADHD symptoms and others had other chief complaints such as interpersonal relationship problems and depressed mood. One or more psychiatric comorbidities were found in 76.4% of the subjects. Only 42.6% of methylphenidate group showed higher adherence than 80%, and 40.0% of atomoxetine group showed higher adherence than 80%. Only 13.8% of methylphenidate group and 18.2% of atomoxetine group showed longer persistence than 365 days. None of the subjects had any substance-related events regarding ADHD medication.

Conclusion: ADHD not only persists into adulthood but is associated with a wide range of psychiatric symptoms and comorbidities. Clinicians should constantly consider the possibility of ADHD when evaluating adult patients. Most importantly, greater emphasis should be placed on improving adherence to pharmacological treatment rather than on the relatively minimal risk of medication abuse or misuse. Enhancing treatment adherence in adults with ADHD has the potential to significantly improve functioning across multiple domains.

Objective: This study aims to investigate the effect of childhood trauma (CT) on the level of hopelessness in individuals diagnosed with methamphetamine use disorder (MUD) and the mediating role of perceived social support in this relationship.

Methods: The study included 43 patients diagnosed with MUD who attended a psychiatric outpatient clinic and 45 healthy controls with similar sociodemographic characteristics. Participants completed a sociodemographic data form, the Childhood Trauma Scale- Short Form, the Multidimensional Scale of Perceived Social Support, and the Beck Hopelessness Scale. Data were analyzed using SPSS 27 and the PROCESS Macro; correlation, group comparisons, and bootstrap-based mediation analysis were applied.

Results: In the group with MUD, CT, and hopelessness levels were significantly higher, while perceived social support levels were lower. Positive correlations were found between trauma and hopelessness, and negative correlations were found between social support and both variables. In the mediation analysis, the direct effect of CT on hopelessness was insignificant (b=0.037, p=0.115), while the indirect effect mediated by perceived social support was significant (b=0.062, 95% confidence interval: 0.028 to 0.101). These findings indicate that perceived social support is mediating in this relationship.

Conclusion: In conclusion, it appears that hopelessness levels in individuals diagnosed with MUD may be affected by CT and that this effect is shaped through social support. The findings emphasize the importance of strengthening social support systems in treatment.

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: This study aimed to adapt and validate the Behavioral Activation for Depression Scale in older adults of Korea (BADS-OK), and to verify its factor structure, internal consistency, convergent and construct validity, and incremental validity in predicting depression, loneliness, and suicidal ideation.

Methods: The cross-sectional study conducted questionnaire surveys and interviews. A total of 110 older adults (20 men and 90 women) participated in the first part, while 102 older adults (14 men and 88 women) participated in the second part. They are recruited form the community mental health centers managing high-risk older adults. The BADS, Valuing Questionnaire, Environmental Reward Observation Scale, Geriatric Depression Scale, Scale for Suicide Ideation, and University of California, Los Angeles Loneliness Scale were used.

Results: Exploratory factor analysis identified an 8-item, 4-factor structure (activation, avoidance/rumination, work/school impairment, and social impairment), which explained 85.2% of the variance and showed high internal consistency. Confirmatory factor analysis confirmed the validity of this structure. The BADS-OK significantly predicted depression, loneliness, and suicidal ideation, demonstrating high convergent and construct validity.

Conclusion: BADS-OK is a reliable and valid tool for assessing BA in older adults, enhancing psychometric understanding, and allowing for easier repeated assessments during BA sessions. Its applicability to the target population, including high-risk groups, and its potential to improve health and quality of life in the aging population, suggest that BADS-OK will be widely used in clinical and research settings.

Objective: It is widely accepted that childhood traumas increase the risk of major depressive disorder (MDD) in adulthood and contribute to the chronicity of the disorder. Various mediating factors are believed to exist in the relationship between childhood trauma and depression. The aim of this study is to investigate the mediating effect of rumination in the relationship between childhood traumatic experiences and MDD in a clinical sample.

Methods: The sample of this cross-sectional study comprised 94 patients aged 18-65 diagnosed with MDD at the Gülhane Training and Research Hospital Psychiatry Clinic, along with 91 healthy participants. After collecting sociodemographic data, participants completed the Beck Depression Inventory, Childhood Trauma Questionnaire-33, and Rumination Scale. Data were analyzed using appropriate statistical methods.

Results: The analyses indicated that rumination may serve a mediating role in the relationship between childhood trauma and depressive symptoms. Specifically, rumination was predicted by childhood trauma (standardized coefficient=0.44, p<0.001) and served as a predictor of depression (standardized coefficient=0.56, p<0.001). The basic model indicated a significant direct effect between childhood trauma and depression severity (p=0.01, b=0.50), while the mediating model demonstrated both a direct effect (p=0.011, b=0.24) and an indirect effect through rumination (p=0.003, b=0.25).

Conclusion: The findings of this study suggest that childhood traumatic experiences may be associated with depression severity, and rumination appears to play a mediating role in this relationship. This highlights the need to address cognitive features and traumatic experiences in developing effective prevention and intervention strategies for depression.

Objective: This study aimed to investigate the neurophysiological characteristics of panic disorder (PD) by analyzing quantitative electroencephalography (QEEG) data, with a particular focus on high beta activity.

Methods: In this retrospective study, resting-state QEEG data from 58 patients with PD and 23 healthy controls (HC) were analyzed. Spectral power was calculated for delta (1-4 Hz), theta (4-8 Hz), alpha (8-12 Hz), beta (12-25 Hz), and high beta (25-30 Hz) bands across frontal, central, and posterior regions. Group differences were assessed using generalized estimating equations, and Pearson correlation analyses were conducted to examine associations between electroencephalography activity and clinical symptoms.

Results: PD patients showed significantly higher high beta power across all regions compared to HC (frontal: estimate=1.276, χ²=12.48, p<0.0010; central: estimate=0.874, χ²=9.87, p=0.0017; posterior: estimate=0.524, χ²=4.48, p=0.0343). Beta power was elevated only in the frontal region (estimate=3.391, χ²=5.31, p=0.0212), while delta power was increased overall (χ²=4.60, p=0.0390) without regional specificity. No significant group differences were observed in alpha or theta bands. A significant positive correlation was found between frontal high beta power and Panic Disorder Severity Scale scores (r=0.41, p=0.010), while no other significant correlations were observed between regional high beta power and clinical scales.

Conclusion: Increased high beta, beta, and delta activity in PD may reflect a neurophysiological imbalance. In particular, elevated high beta power may indicate hyperarousal and excessive cognitive control in PD, suggesting its potential as a future biomarker.

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.