Psychiatry Investigation最新文献

Objective: This study investigated the clinical features and personality traits of pediatric and adult patients with avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa-restricting type (RAN) in a Korean hospital cohort, and the distinct characteristics of ARFID in a non-Western sample.

Methods: This retrospective cohort study included 392 Korean outpatients with ARFID (n=68) or RAN (n=324) at an eating disorders clinic. Clinical characteristics including eating and general psychopathology, and personality traits based on the five-factor model and behavior inhibition/activation systems were assessed. The eating and general psychopathology and personality traits of pediatric and adult patients with ARFID were retrospectively investigated alongside those of pediatric and adult RAN patients.

Results: Patients with ARFID had an earlier onset age, a longer illness duration, and lower levels of eating and general psychopathology compared to those with RAN. ARFID patients also reported lower levels of neuroticism and behavioral inhibition. Pediatric ARFID patients showed less severe general psychopathology than adult patients with ARFID, while personality traits were consistent across age groups. However, pediatric RAN patients demonstrated higher dietary restraint and lower levels of general psychopathology compared to adult patients.

Conclusion: This study highlights distinct psychopathology and personality traits between ARFID and RAN. These findings emphasize the importance of age-specific interventions for ARFID. Compared to pediatric patients, adult patients with ARFID require interventions targeting psychological difficulties. The results underscore the need to improve recognition of ARFID in Korea.

Objective: The aim of the study is to explore the relationship between family accommodation, emotion regulation difficulties, and alexithymia in obsessive-compulsive disorder (OCD).

Methods: The study group consisted of 107 individuals diagnosed with OCD, while the control group included 151 healthy individuals. Sociodemographic data form, Yale-Brown Obsessive Compulsive Scale (YBOCS), Family Accommodation Scale-Patient Version (FASPV), Toronto Alexithymia Scale (TAS), and Difficulties in Emotion Regulation Scale (DERS) were used to collect data.

Results: In our study, it was found that the median DERS and TAS scores of the participants were significantly higher in the OCD group than in the control group. A moderate positive correlation was found between FAS-PV and the total score of YBOCS (p=0.002, r=0.302). Statistically significant, low to moderate, positive correlations were observed between FAS-PV and the total score of DERS (p=0.001, r=0.319). Furthermore, a statistically significant, moderate to low correlation was found between YBOCS and the total score of DERS. A positive and substantial influence on FAS-PV is provided by the YBOCS variable (B=0.571, p=0.01).

Conclusion: In conclusion, this study found that difficulty in emotion regulation and alexithymia levels were higher in individuals with OCD compared to healthy controls, and that family accommodation was related to both difficulties in emotion regulation and alexithymia. Finally, it was determined that difficulty in emotion regulation has a mediating effect in the relationship between family accommodation and alexithymia. It is suggested that longitudinal studies be conducted to further support the data presented by this study.

Objective: The nine diagnostic criteria for Internet Gaming Disorder (IGD) proposed in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) have been widely adopted, but have also faced significant criticism. This study evaluated the psychometric properties of the nine DSM-5 criteria for IGD using item response theory (IRT).

Methods: Four DSM-5-based scales, including the Game Addiction Scale, the Internet Gaming Disorder Scale Short-Form, the Ten- Item Internet Gaming Disorder Test, and the Internet Gaming Disorder Scale, were administered to 1,530 Chinese adolescents and young adults. IRT models were used to assess the psychometric properties of these criteria. The potential for differential item functioning (DIF) related to sex and between adolescents and adults was also evaluated.

Results: All nine DSM-5 criteria demonstrated very high to perfect discrimination (a >1.38), providing substantial diagnostic information (item information >0.476) for diagnosing IGD. These scales, despite variations in wording and scoring methods, exhibited strong correlations in total scores (r≥0.502, p<0.001) and high consistency (Kendall's W ≥0.656, p<0.05) concerning the fitted IRT parameters. Among the nine criteria, escape showed the lowest cross-scale discrimination, item information, and difficulty. In contrast, withdrawal showed the highest item information and discrimination, and the second highest difficulty. Additionally, there was no evidence of DIF related to sex or age (adolescents vs. adults) across nearly all scale items.

Conclusion: These findings indicate that the nine DSM-5 criteria generally possess acceptable psychometric properties for diagnosing IGD. Notably, withdrawal may represent a core symptom of IGD. Conversely, escape demonstrated inferior performance compared to the other eight criteria, indicating a potential need for further revision.

Objective: The aim of the study is to evaluate the efficacy of a karaoke-based digital therapeutic program (CogniSong) in patients with mild cognitive impairment (MCI).

Methods: In a 12-week single-center, assessor-blinded randomized controlled trial, 36 patients with MCI were randomly assigned to either the CogniSong digital therapeutics (DTx) group (n=18) or standard treatment group (n=18). The intervention group underwent daily 30-minute karaoke game-based cognitive training sessions via a mobile application. The primary outcome was the change in Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) total score from baseline to week 12. Secondary outcomes included RBANS subdomain index scores, the Seoul-Instrumental Activities of Daily Living, 17-item Hamilton Depression Rating Scale, Neuropsychiatric Inventory, and Clinical Dementia Rating-Sum of Boxes.

Results: The DTx group showed a significantly greater improvement in RBANS total score compared to standard treatment group (mean change +5.9 points vs. -0.2 points, p=0.041). However, there were no significant between-group differences in RBANS subdomain scores or secondary outcomes such as daily functioning, mood, neuropsychiatric symptoms, or global clinical status.

Conclusion: In this randomized controlled trial, a karaoke-based DTx appeared feasible and effective in enhancing global cognition in MCI. The findings support its potential as a complementary intervention for cognitive improvement in MCI patients.

Objective: The study aimed to investigate whether RSPO2 gene polymorphisms are associated with schizophrenia susceptibility, focusing on five specific single nucleotide polymorphisms (SNPs). Additionally, the study evaluated the expression of Rspo2 in a schizophrenic-like mouse model and examined its relationship with clinical symptoms.

Methods: The study included 159 schizophrenia patients and 448 controls. Clinical symptoms were assessed using the Operational Criteria Checklist for Psychotic Illness. Genotyping of five RSPO2 SNPs was performed to identify potential genetic associations with schizophrenia. Rspo2 mRNA expression levels were measured in the brains of MK-801-induced schizophrenic-like mice. Functional analysis of the rs374810 SNP was conducted using a luciferase assay to evaluate its effect on gene activity. Statistical analyses were used to compare genotype and allele frequencies and assess correlations with clinical outcomes.

Results: Significant associations were found between schizophrenia and two SNPs, rs374810 and rs423940. The A allele of rs374810 and the T allele of rs423940 were linked to an increased risk of schizophrenia (p=0.0049 and p=0.0044, respectively). Functional analysis revealed that the A allele of rs374810 significantly increased luciferase activity compared to the G allele, indicating a potential functional role. RSPO2 expression was also altered in the schizophrenic-like mouse model, suggesting its involvement in schizophrenia pathogenesis.

Conclusion: The findings indicate that RSPO2 gene polymorphisms, particularly rs374810 and rs423940, may contribute to schizophrenia susceptibility. Therefore, RSPO2 expression may be associated with the susceptibility to schizophrenia in the Korean population.

Objective: This study aimed to assess the prevalence of comorbid of smartphone addiction and depressive symptoms and identify their common and distinct risk factors among college students.

Methods: A total of 8,347 Chinese college students participated in the study by completing questionnaires that assessed individual, family, school, and peer factors, as well as smartphone addiction and depressive symptoms. Multivariate logistic regression was conducted to explore the risk of smartphone addiction only, depressive symptoms only, and their comorbidity.

Results: The prevalence rates of smartphone addiction only, depressive symptoms only, and their comorbidity were 30.5%, 8.9%, and 25.3%, respectively. Higher frequency of mobile phone use in lessons and lower level of school belonging were associated with the increased risk of all three disease outcomes. There was a dose-response relationship between the number of risk exposures and the three disease outcomes.

Conclusion: The more risk factors of college students were exposed to, the more likely they were to develop smartphone addiction only, depressive symptoms only, and their comorbidity. Targeted preventive measures and solutions should be implemented to reduce the occurrence of smartphone addiction and depressive symptoms.

Objective: Suicidal behavior among adolescents has become increasingly prevalent in recent years, positioning suicide as one of the leading causes of death in this age group worldwide. Despite this growing public health concern, country-specific data remain limited, particularly in Türkiye. This study aimed to examine the sociodemographic and clinical characteristics of adolescents referred to psychiatric services following a suicide attempt in Türkiye.

Methods: We enrolled adolescents (12-18 years) who presented to the Pediatric Emergency Department after a suicide attempt and were subsequently referred to our clinic. Participants completed a Sociodemographic Data Form and underwent the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version interview to assess lifetime psychiatric diagnoses.

Results: Among the 60 participants, 86.7% were female and 13.3% were male. The mean age was 184.7±13.6 months (range: 144-211 months). Two-thirds (66.7%) met criteria for at least one psychiatric disorder; major depressive disorder was most prevalent (41.7%). The predominant method of attempt was medication ingestion, and family conflict was identified as the leading precipitant (56.7%). A history of prior suicide attempts was reported by 40%, and 33.3% had a family history of suicide. Notably, 70% had engaged in non-suicidal self-harming behavior (SHB) before their attempt.

Conclusion: Suicide attempts peak during middle adolescence, and female adolescents are at higher risk. Clinicians should monitor warning signs such as a prior history of SHB. Given the high prevalence of psychiatric disorders in both these adolescents and their parents, early identification and intervention are essential to prevention.

Objective: We aimed to investigate whether the risks of suicide and non-suicide death vary based on the presence of psychiatric disorders.

Methods: Patients diagnosed with psychiatric disorders in South Korea between January 1, 2017, and December 31, 2017, were included and referred to as the psychiatric disorder (PY) group. A comparison group, the non-PY group, included individuals who had never been diagnosed with psychiatric disorders, selected using a 1:1 stratified random sampling technique based on age and sex. The patients were followed up for death by suicide (primary endpoint) from January 1, 2018 to December 31, 2022. All other causes of death were categorized as non-suicidal deaths.

Results: After 1:1 propensity score (PS) matching, 761,384 adult participants (380,692 in each group) were finally included. Of these, 0.2% (830/380,692) of individuals in the PY group died by suicide, compared with <0.01% (13/380,692) in the non-PY group. The PY group had a 64.43-fold higher risk of suicide death (hazard ratio [HR]: 64.43, 95% confidence interval [CI]: 37.25-111.43, p<0.001) compared to the non-PY group. Additionally, 8.6% (32,746/380,692) of the PY group died from non-suicidal causes, while 7.1% (27,043/380,692) of the non-PY group died from non-suicidal causes. PY group had a 1.22-fold higher risk of non-suicidal death (HR: 1.22, 95% CI: 1.20-1.24, p<0.001) compared to the non-PY group.

Conclusion: Psychiatric disorders were associated with a significantly elevated suicidal risk in South Korea, which was substantially greater than the risk of non-suicidal deaths.

Objective: Employment status is a key indicator of socioeconomic status, and unstable employment conditions can cause various social problems. However, research in Asian populations on the association between employment status and mental health, particularly suicidal ideation, remains relatively limited. This study investigated the association between employment status and suicidal ideation in general population in South Korea.

Methods: Using data from the 2015, 2017, and 2019 Korea National Health and Nutrition Examination Survey (KNHANES), 6,509 participants aged ≥20 years were analyzed. Suicidal ideation was characterized by individuals considering suicide seriously within the past year. Covariates were adjusted to account for factors such as sociodemographic, health behavior, and mental health factors. Multivariable logistic regression was performed, along with stratified analyses by subgroups of sociodemographic, health behavior, and mental health factors to assess effect modification.

Results: In our KNHANES data analysis, unemployed individuals had 1.85 times higher odds of reporting suicidal ideation compared to employed individuals (adjusted odds ratio, 1.85; 95% confidence interval, 1.41-2.44; p<0.001). In subgroup analysis, all covariates- except women and low body mass index-showed effect modification on the association between employment status and suicidal ideation.

Conclusion: This study demonstrated that unemployed status was significantly associated with increased suicidal ideation. These findings suggest that further research and policy attention are warranted to better understand and address the mental health needs of unemployed individuals.

Objective: Attention-deficit/hyperactivity disorder (ADHD) frequently persists into adulthood and leads to significant impairment across multiple domains. Cognitive behavioral therapy (CBT) has been proposed as a promising adjunctive treatment. We aimed to evaluate the effectiveness of a structured group-based CBT program for adults with ADHD and examine whether cognitive ability and treatment adherence moderate treatment response.

Methods: A retrospective analysis was conducted on 24 adults who completed a 10-session group CBT program. ADHD symptoms were assessed pre and postintervention using the Adult ADHD Self-Report Scale (ASRS) and Korean Adult ADHD Rating Scale (K-AARS). Subgroup analyses were performed based on full-scale intelligence quotient (FSIQ), session attendance, and presence of comorbid depression.

Results: A significant improvement in symptoms was observed across most ASRS and K-AARS domains. Functional impairment, as measured using the K-AARS impairment subscale, also improved significantly. Participants with an average FSIQ (90-109) showed the most consistent improvements, whereas those with below-average and high FSIQ also benefited to varying degrees. Higher attendance rates were associated with greater reduction in symptoms. The presence of comorbid depression did not significantly affect the treatment outcomes.

Conclusion: Group-based CBT is an effective adjunct intervention for managing adult ADHD symptoms. Notably, the intervention led to significant improvements in functional impairment, highlighting its potential to enhance daily functioning in adults with ADHD. Tailoring interventions based on cognitive profiles and emphasizing treatment adherence may enhance therapeutic outcomes. Future studies should employ larger sample sizes, randomized controlled designs, and longitudinal follow-up assessments to validate and extend these findings.