1.Psychological Inflexibility, Cognitive Fusion, and Thought–Action Fusion as a Transdiagnostic Construct: Direct Comparisons Among Major Depressive Disorder, Obsessive–Compulsive Disorder, and Healthy Controls
Sang Won LEE ; Seung Jae LEE ; Mina CHOI
Psychiatry Investigation 2025;22(1):93-101
Objective:
Evidence suggests that acceptance and commitment therapy (ACT) processes function as transdiagnostic factors in both major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) individually. However, few studies have directly compared these two clinical disorders. Therefore, this study aimed to identify potential transdiagnostic factors associated with ACT across MDD, OCD, and healthy control (HC) groups.
Methods:
A total of 34 MDD patients, 43 OCD patients, and 46 HCs were recruited through subway advertisements and outpatient services at a university hospital. Participants completed the Acceptance and Action Questionnaire-II, Cognitive Fusion Questionnaire, thought-action fusion (TAF) scale, and symptom severity scales.
Results:
Direct group comparisons revealed higher psychological inflexibility, cognitive fusion, and likelihood of TAF in the clinical groups compared to the HCs, with no differences between the MDD and OCD groups. These three transdiagnostic factors were variously correlated with both depressive and obsessive–compulsive (OC) symptoms in all groups. Regression analyses demonstrated that the three transdiagnostic factors accounted for 26% of the depressive symptoms in the MDD group (R2=0.26, p=0.028) and 27% of the OC symptoms in the OCD group (R2=0.27, p=0.014).
Conclusion
These findings from the direct group comparisons of the three groups confirmed that psychological inflexibility, cognitive fusion, and likelihood of TAF are potential transdiagnostic factors that moderately contribute to the primary symptoms of both MDD and OCD. From another perspective, these results also highlight the need to consider how ACT addresses disorder-specific variations beyond what is explained by these transdiagnostic factors in the future.
2.Diabetes Is Positively Associated With High Risk of Depression in Korean Cervical Cancer Patients: Korean National Health and Nutrition Examination Survey 2010–2021
Seon-Mi LEE ; Daun SHIN ; Aeran SEOL ; Sanghoon LEE ; Hyun-Woong CHO ; Kyung-Jin MIN ; Jin-Hwa HONG ; Jae-Kwan LEE ; Nak-Woo LEE ; Jae-Yun SONG ; Won Jun CHOI
Psychiatry Investigation 2025;22(1):57-65
Objective:
Objective of this study is to evaluate the association between high risk of depression and metabolic diseases such as hypertension, diabetes, and dyslipidemia in Korean cervical cancer patients.
Methods:
A total of 330 women with cervical cancer were included in this study, using data from the Korea National Health and Nutrition Examination Survey from 2010 to 2021. Participants were categorized into two groups—high risk of depression and non-depression—based on their answers to survey items related to depression. A multivariate logistic regression analysis was used to evaluate the influence of metabolic diseases on high risk of depression in patients with cervical cancer.
Results:
A total of 78 (23.64%) and 252 (76.36%) women were classified into the high risk of depression and non-depression groups, respectively. In multivariate logistic regression analysis adjusting for age, menopausal status, and smoking status, diabetes was associated with an odds ratio of 2.47 (95% confidence interval: 1.205, 5.071) for high risk of depression in cervical cancer patients. However, among the metabolic diseases, hypertension, and dyslipidemia were not associated with high risk of depression in patients with cervical cancer.
Conclusion
This study suggests that diabetes may be associated with a increased risk of high risk of depression in cervical cancer patients. Therefore, appropriate treatment of diabetes in cervical cancer patients may contribute to lowering the risk of depression in the future.
3.Sexual Victimization and Psychological and Behavioral Outcomes Among Children and Adolescents in South Korea
Hyun Ji LEE ; Jungtae CHOI ; Jae-Won KIM ; Kihyun KIM
Psychiatry Investigation 2025;22(5):564-573
Objective:
By focusing on a person-centered approach using latent class analyses (LCA), this study examined the patterns of sexual victimization among children and adolescents in South Korea and compared the psycho-behavioral outcomes of these classes.
Methods:
Participants were 546 females aged 6–17, including 117 sexual victimization survivors and 429 non-victims in South Korea. LCA, an analysis of covariance, and Bonferroni post-hoc tests were conducted. Psychological and behavioral outcomes were measured using the Korean version of the Child Behavior Checklist 6–18 and the Youth Self Report. Variables include internalizing (anxious/depressed, withdrawn/depressed, somatic complaints), externalizing (rule-breaking, aggressive behavior), social, thought, and attention problems.
Results:
Based on the fit statistics, proportion of each class, and interpretability, a three-class solution was selected as the best fitting model. Profile 1 mainly involved survivors of rape, which first occurred in adolescence through social relations involving alcohol, drugs, or filming. Profile 2 mainly comprised survivors of both rape and physical sexual harassment by close relations, such as family members or relatives, more than once. Profile 3 mainly comprised survivors of sexual harassment by strangers or social relations. Statistically significant differences were suggested in the psych-behavioral outcomes of the profiles compared with the non-victim group.
Conclusion
These findings highlight the importance of examining experiences of sexual violence in a multifaceted manner. This approach may provide more effective interventions for survivors and allow clinicians to gain an in-depth understanding of sexual victimization in children and adolescents while also increasing the understanding of potential psycho-behavioral consequences.
4.Rapidly Growing Gastrointestinal Stromal Tumor on the Esophagus
Ji Hye PARK ; Sung Eun KIM ; Seun Ja PARK ; Moo In PARK ; Won MOON ; Jae Hyun KIM ; Kyoungwon JUNG ; Myung Hun LEE
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2025;25(1):64-69
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms that mainly occur in the stomach and small intestine; those arising in the esophagus are rarer. A 54-year-old woman was referred to our hospital with a one-month history of dysphagia. Esophagogastroduodenoscopy (EGD), performed approximately five months earlier, had not revealed any specific findings. However, an EGD performed in our hospital showed the presence of a round, protruding lesion (approximately 40×30 mm in size), with a normal overlying mucosal surface, 35–39 cm from the upper incisor. Chest computed tomography (CT) revealed a large esophageal mass. Enucleation was performed on the esophageal mass, and a GIST was diagnosed using immunochemical staining. Imatinib mesylate administration was initiated two months postoperatively. The patient was stable, without any evident recurrence in the 8-month postoperative follow-up EGD and chest CT examinations. Therefore, physicians should consider that patients with worsening dysphagia may have an underlying organic condition, such as an acute increase in size of an esophageal GIST, even if recent examinations were unremarkable.
5.A Preterm Infant with TTN Gene Mutation Presenting with Cardiac Tamponade and Hydrops Fetalis: A Case Report
Jae Hun JEONG ; Young Hyun KIM ; Dong Won LEE
Neonatal Medicine 2025;32(1):49-54
Hydrops fetalis is a condition characterized by excessive fluid accumulation in the fetus, and is classified into immune and non-immune types depending on the underlying disease. Among cases of non-immune hydrops fetalis (NIHF), 15% to 20% are of cardiac origin, and genetic factors such as titin (TTN) gene mutations can contribute to cardiac dysfunction. We report the case of a preterm infant (29+2 weeks, 1,430 g) with hydrops fetalis who developed cardiac tamponade due to major pericardial effusion. Seven hours after birth, the heart rate suddenly decreased, and blood pressure could not be measured. Transthoracic echocardiography revealed substantial pericardial effusion and severely impaired cardiac function, and the preterm infant was diagnosed with pericardial tamponade. Emergency pericardiocentesis was performed, which led to hemodynamic stabilization. Genetic testing identified two heterozygous TTN mutations (c.13898A>T and c.27856G>T), with the latter presumed responsible for the observed cardiac dysfunction. The mother was found to carry the c.13898A>T mutation, but was asymptomatic. This case report highlights the importance of genetic testing in neonates with unexplained NIHF and cardiac complications. Identifying TTN gene mutations provides valuable insights into the underlying pathophysiology and guides clinical management.
7.Far-Lateral Transforaminal Unilateral Biportal Endoscopic Lumbar Discectomy for Upper Lumbar Disc Herniations
Jin Seop HWANG ; Sang Hyub LEE ; Dain JEONG ; Jae-Won JANG ; Yong Eun CHO ; Dong-Geun LEE ; Choon Keun PARK ; Chung Kee CHOUGH
Neurospine 2025;22(1):14-27
Objective:
The upper lumbar region has distinctive anatomical characteristics that contribute to the challenges of performing discectomy. We introduce far-lateral transforaminal unilateral biportal endoscopic (UBE) lumbar discectomy for central or paracentral disc herniations in the upper lumbar region.
Methods:
We conducted retrospective review of the patients who underwent a far-lateral transforaminal UBE lumbar discectomy at our institution from January 2018 to September 2024. The electronic medical records, operative records, and radiologic images of the patients were reviewed.
Results:
A total of 27 patients underwent far-lateral transforaminal UBE lumbar discectomy for central or paracentral disc herniations in the upper lumbar region. The patient had a mean age of 54.0 ± 13.7 years. Operation was performed at the L1–2 level in 3 patients (11.1%), L2–3 in 9 patients (33.3%), and L3–4 in 15 patients (55.6%). The patients were followed-up for a mean of 27.7 ± 19.3 months. The Oswestry Disability Index was significantly decreased from 36.3 ± 6.8 preoperatively to 3.7 ± 3.3 at last follow-up (p < 0.001). The visual analogue scale (VAS) back was significantly decreased from 7.8 ± 0.9 preoperatively to 3.1 ± 0.6 postoperative day 2 (p < 0.001). The VAS leg was significantly decreased from 8.1 ± 0.8 preoperatively to 2.3 ± 0.7 postoperative day 2 (p < 0.001).
Conclusion
The far-lateral transforaminal UBE lumbar discectomy would be a viable surgical option for upper lumbar disc herniations.
8.Clinical practice in office hysteroscopy
Namkung JEONG ; Angela CHO ; Yu-Jin KOO ; Jun-Woo AHN ; Hyuntae PARK ; Eun Sil LEE ; Sang Wook YI ; Won Duk JOO ; Sang-Hoon LEE ; Jae Kwan LEE ; Sa Ra LEE ;
Obstetrics & Gynecology Science 2025;68(3):175-185
Hysteroscopy is particularly valuable for the diagnosis of uterine cavity abnormalities through direct visualization. The development of office hysteroscopy has expanded the range of diagnostic and surgical procedures available. These detailed guidelines include patient counseling and the selection and setting of office hysteroscopy, including room, equipment, and medical staff. Analgesia or local anesthesia is often required in selective office hysteroscopy cases. Cervical dilation and preparation using medical or mechanical methods are required for most diagnostic hysteroscopic procedures. Methods for optimizing visualization and choosing suitable distension media are important for a successful office hysteroscopy. It is crucial to adhere to guidelines to prevent complications, such as vasovagal syncope, cervical trauma, uterine perforation, fluid overload, and embolism. Vaginoscopy can be a good alternative option for alleviating pain, especially in cases where the insertion of a vaginal speculum is expected to be challenging.
9.Psychological Inflexibility, Cognitive Fusion, and Thought–Action Fusion as a Transdiagnostic Construct: Direct Comparisons Among Major Depressive Disorder, Obsessive–Compulsive Disorder, and Healthy Controls
Sang Won LEE ; Seung Jae LEE ; Mina CHOI
Psychiatry Investigation 2025;22(1):93-101
Objective:
Evidence suggests that acceptance and commitment therapy (ACT) processes function as transdiagnostic factors in both major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) individually. However, few studies have directly compared these two clinical disorders. Therefore, this study aimed to identify potential transdiagnostic factors associated with ACT across MDD, OCD, and healthy control (HC) groups.
Methods:
A total of 34 MDD patients, 43 OCD patients, and 46 HCs were recruited through subway advertisements and outpatient services at a university hospital. Participants completed the Acceptance and Action Questionnaire-II, Cognitive Fusion Questionnaire, thought-action fusion (TAF) scale, and symptom severity scales.
Results:
Direct group comparisons revealed higher psychological inflexibility, cognitive fusion, and likelihood of TAF in the clinical groups compared to the HCs, with no differences between the MDD and OCD groups. These three transdiagnostic factors were variously correlated with both depressive and obsessive–compulsive (OC) symptoms in all groups. Regression analyses demonstrated that the three transdiagnostic factors accounted for 26% of the depressive symptoms in the MDD group (R2=0.26, p=0.028) and 27% of the OC symptoms in the OCD group (R2=0.27, p=0.014).
Conclusion
These findings from the direct group comparisons of the three groups confirmed that psychological inflexibility, cognitive fusion, and likelihood of TAF are potential transdiagnostic factors that moderately contribute to the primary symptoms of both MDD and OCD. From another perspective, these results also highlight the need to consider how ACT addresses disorder-specific variations beyond what is explained by these transdiagnostic factors in the future.
10.Diabetes Is Positively Associated With High Risk of Depression in Korean Cervical Cancer Patients: Korean National Health and Nutrition Examination Survey 2010–2021
Seon-Mi LEE ; Daun SHIN ; Aeran SEOL ; Sanghoon LEE ; Hyun-Woong CHO ; Kyung-Jin MIN ; Jin-Hwa HONG ; Jae-Kwan LEE ; Nak-Woo LEE ; Jae-Yun SONG ; Won Jun CHOI
Psychiatry Investigation 2025;22(1):57-65
Objective:
Objective of this study is to evaluate the association between high risk of depression and metabolic diseases such as hypertension, diabetes, and dyslipidemia in Korean cervical cancer patients.
Methods:
A total of 330 women with cervical cancer were included in this study, using data from the Korea National Health and Nutrition Examination Survey from 2010 to 2021. Participants were categorized into two groups—high risk of depression and non-depression—based on their answers to survey items related to depression. A multivariate logistic regression analysis was used to evaluate the influence of metabolic diseases on high risk of depression in patients with cervical cancer.
Results:
A total of 78 (23.64%) and 252 (76.36%) women were classified into the high risk of depression and non-depression groups, respectively. In multivariate logistic regression analysis adjusting for age, menopausal status, and smoking status, diabetes was associated with an odds ratio of 2.47 (95% confidence interval: 1.205, 5.071) for high risk of depression in cervical cancer patients. However, among the metabolic diseases, hypertension, and dyslipidemia were not associated with high risk of depression in patients with cervical cancer.
Conclusion
This study suggests that diabetes may be associated with a increased risk of high risk of depression in cervical cancer patients. Therefore, appropriate treatment of diabetes in cervical cancer patients may contribute to lowering the risk of depression in the future.

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