The importance of behavioral health after disaster must not overlooked when responding to an event. After disaster, victims experience various difficulties, which responders must keep in mind. They may frighten and confused to cooperate properly with assistance. Persistent distorted blame of self or others for the cause and result of the event is common while different degrees. Behavioral health, which major role is to relieve peoples suffering, also could help cooperation of rescues and accelerate fast recovery after the trauma. Distress of disaster victim could be presented with somatic complaints. Sudden increase of nonspecific physical complaint could be result of somatization of mental stress, which is often observed in disaster victims. After 'Sewol ship sunk' there were lots of need for behavioral health. We now know that how disastrous it could be and how desperate it would be while considering issues of peoples in need for psychological support after disaster. Not to end up in this hopeless situation, it is time to think about how to establish persistent framework to help disaster victims hidden overwhelming sufferings.
Disaster Victims ; Disasters* ; Ships

Depression is a frequent cause of suicide. Although there have been reports that SSRIs might increase suicidal ideations and behaviors, most studies found antidepressants are effective treatments of suicidal ideations and behaviors. Antidepressants have also been shown to have prophylactic effects in preventing suicidal behaviors. Most double-blind studies do not suggest a causal relationship between antidepressant and the increased suicidality. Our review results suggest that the undertreatments of depression are more significant problems with the use of antidepressants in suicidal patients.
Antidepressive Agents ; Depression ; Double-Blind Method ; Humans ; Suicidal Ideation ; Suicide*

Traumatic injury can result not only in physical disability but also in mental and behavioral sequelae. It is very important to properly judge the severity of disability as well as the need for assistance and future medical treatment. It is very difficult to establish objective guidelines for assessing mental and behavioral disabilities due to the inherent peculiarity of the disabilities. This study uses reports generated for court because they need to be more judicious than reports for other types of evaluation. We analyzed reports concerning the facts and problems associated with evaluation of mental and behavioral disabilities. We hope this study will help further our understanding of mental and behavioral disabilities.

Percutaneous Endopyelotomy is a natural outgrowth of technique developed for percutaneous ureteral and renal stone removal. In it`s comparison to the Davis ureterotomy technique, a rationale for this procedure and explanation for it`s success is provided. Endopyelotomy, which we performed experimentally to prevent recurrent stone formation, has now matured into a viable procedure under the certain guideline. This procedure has become our first choice for secondary ureteropelvic junction obstruction but primary cases were not experienced. Although classical pyeloplasty must be main surgical means to UPJ obstruction, technical and equipmental advanced could be enabled us to perform 8 endopyelotomy. We incised UPJ obstruction in 8 cases with direct vision nephroscope inserted through a percutaneous nephrostomy tract and ureteroscope. In 6 patients, renal calculi were removed endourologically during same and separate session. There were no immediate complication and nephrostogram showed adequate drainage in all cases.
Drainage ; Humans ; Kidney Calculi ; Nephrostomy, Percutaneous ; Ureter ; Ureteroscopes

OBJECTIVES: The evaluation of disability after trauma in psychiatry is relatively subjective compared with other departments. A consensus among evaluators could improve reliability of evaluations. We compared disability rate of common psychiatric disorders without definite brain injury depending on their diagnosis from experienced evaluators in Korea. METHODS: A written questionnaire was mailed to each evaluator and the reply was analyzed. The questions included disability rate ranges of postconcussional syndrome, PTSD and depression. Other questions related with admission for evaluation, expected duration of treatment, life expectancy and need of supporting person were also asked. RESULTS: Range of disability rate were from 8.6+/-4.5% to 26.6+/-12.8% in postconcussional syndrome, from 10.4+/-6.8% to 36.4+/-13.8% in PTSD and from 10.0+/-4.6% to 30.6+/-10.3% in depressive disorder. There were lots of diversity in expected duration of treatment with psychiatric disability. Decline of life expectancy and need of supporting person were considered at least 50% of disability. CONCLUSION: There is much diversity in evaluation of psychiatric disabilities with disability rate and expected duration of treatments even among experienced evaluators. A common consensus among experts may increase reliability of psychiatric evaluations after trauma.
Brain Injuries ; Consensus ; Depression ; Depressive Disorder ; Humans ; Korea ; Life Expectancy ; Postal Service ; Stress Disorders, Post-Traumatic ; Surveys and Questionnaires

OBJECTIVES: Recent studies have raised the possibility that nerve growth factor(NGF) is abnormally regulated in the central nervous system(CNS) of animal models with alcohol dependence. The possible alteration of NGF by prolonged alcohol intake may play an important role in alcohol-induced neurotoxicity. Carbohydrate-deficient transferrin(CDT) is regarded as a reliable biological marker of alcohol dependence. The goal of this study was to estimate the changes of %CDT and serum NGF level according to the duration of alcohol abstinence, and to identify whether %CDT level is associated with the serum NGF level in the patients with alcohol dependence. METHODS: The subjects were 24 patients with alcohol dependence. We used the Axis-Shield ASA to measure the %CDT level and the enzyme-linked immunosorbent assay(ELISA) to measure the serum NGF level. %CDT and NGF levels were measured immediately after the admission and at 2 weeks after the admission. RESULTS: Decreased %CDT were observed during the period of 2 weeks after the admission. NGF level was not significantly different after 2 weeks. The NGF levels were not correlated with %CDT. The possibility of %CDT as a predictor of alcohol-induced neurotoxicity was not confirmed. CONCLUSION: Serum NGF levels is not a reliable indicator of abstinence state in the patients with alcohol dependence. Further studies are needed to evaluate the relation between two indicators in regard to hematological and neurological changes in alcohol dependence.
Alcohol Abstinence ; Alcoholism* ; Biomarkers ; Humans ; Models, Animal ; Nerve Growth Factor* ; Transferrin*

We sought to gain insights on the prevalence of psychiatric disorders, the risk and protective factors and the prevention and intervention programs of mental health problems among disaster workers. The prevalence of Posttraumatic Stress Disorder (PTSD) among disaster workers was higher than that of the general population and lower than that of disaster survivors. They might suffer from various mental health problems and comorbid disorders. Those mental problems could affect not only their physical health but also self-medication, life satisfaction, and job functioning. Heterogeneous and various factors were positively and negatively associated with psychiatric problems. Prevention and intervention programs were summarized for PTSD among disaster workers. Self-help technique 'RESCUE' and cognitive behavior therapy, developed especially for disaster workers was introduced. Future research and directions were suggested.
Cognitive Therapy ; Disasters* ; Humans ; Mental Health* ; Prevalence ; Stress Disorders, Post-Traumatic ; Survivors

OBJECTIVE: Several tests can be used to screen for alcohol dependence (AD), a prevalent disease with a heterogeneous etiology. As some patients with AD have a strong familial tendency in this regard, a family history of alcohol use disorders can affect the outcomes of screening tests and diagnostic evaluations for AD. In this study, we evaluated associations between a family history of alcohol use disorders and evaluations using the Cut down, Annoyed, Guilty, Eye-opener (CAGE) test, Alcohol Use Disorder Identification Test (AUDIT), and Diagnostic and Statistical Manual of Mental Disorders-fourth edition (DSM-IV) diagnostic criteria among patients with AD. METHODS: We recruited 487 male patients with AD from eight hospitals in Korea. Patients were evaluated using the CAGE, AUDIT, and DSM-IV diagnostic criteria. Patients with and without family histories were compared in terms of these assessment tools. RESULTS: Drinking initiation, uncontrollable drinking, and problem drinking occurred earlier and CAGE "annoyed" scores were higher in patients with a family history. Alcohol problems before the age of 25 years, frequency of spontaneous or compulsive alcohol-seeking behavior, and frequencies of psychological dependence and guilt related to alcohol use were also higher. CONCLUSION: Earlier drinking problems, higher scores on specific items of the CAGE, and AUDIT, and meeting more diagnostic criteria indicate more dependent, harmful drinking by patients with AD who have a family history of this condition. Clinicians should consider patients' family history of alcohol use disorders when screening for AD to identify the correct diagnosis and develop appropriate treatment plans for these patients.
Alcoholism ; Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Guilt ; Humans ; Korea ; Male ; Mass Screening

Objective: Previous studies regarding the relationship between the risk of breast cancer (BC) and antipsychotics use have reported inconsistent findings. Insufficient sample size and/or observation period may have hindered revealing the risk of BC associated with antipsychotics use. We aimed to investigate whether the use of second-generation antipsychotics (SGA) is associated with increased risk of BC. Methods: We used the Health Insurance Review Agency database in South Korea between 2008 and 2018. The index date was determined as the date of the first antipsychotic prescription. We selected women prescribed SGAs for more than 30 days within a year from the index date and age-matched controls, yielding 498,970 cases and 997,940 controls.The Cox proportional hazards regression model was used for estimating the risk. Results: The incidence rates of BC were 109.74 and 101.51 per 100,000 person-years in the case and control groups, respectively. There was an increased risk of BC in the case group (hazard ratio [HR] = 1.08, 95% confidence interval [CI] 1.04−1.13). There was a higher risk of BC in subjects prescribed with ≥ 10,000 mg of olanzapine equivalent dose (HR = 1.29, 95% CI 1.14−1.46) than those with ＜ 10,000 mg (HR = 1.05, 95% CI 1.00−1.11). The increased risk of BC in the case group became significant after six years of the observation period (≥ 6 years: HR = 1.24, 95% CI 1.14−1.35, 3 to ＜ 6 years: HR = 1.06, 95% CI 0.97−1.15, ＜ 3 years: HR = 1.02, 95% CI 0.95−1.09). Conclusion This study indicated that the use of SGAs is associated with increased risk of BC in a long-term relationship with a dose-response pattern.

Objective: Long-acting injectable (LAI) antipsychotics, such as paliperidone palmitate (PP), are known to improve treatment adherence in patients with schizophrenia, which can lead to reductions in relapse and hospitalization rates. However, relatively few studies have demonstrated the economic impact of LAIs, especially in Asian populations. Methods: We conducted a claim-based mirror-image study to explore changes in healthcare utilization and associated costs, among 1,272 South Korean patients with schizophrenia (ICD-10-CM code F20), between the 1-year periods before and after the initiation of PP treatment. Results: Patients accessed outpatient services more frequently after versus before starting PP treatment, with the number of prescription days increasing by 133.45 (p ＜ 0.0001) and the associated costs increasing by USD 1,497.15 (p ＜ 0.0001). The number of admission days was reduced by 11.33 after starting PP treatment (p ＜ 0.0001) and the associated costs were reduced by USD 1,220.75 (p ＜ 0.0001). However, admission cost savings were different according to patients’ oral drug compliance. The daily dosages for benztropine, procyclidine, and propranolol decreased, showing that there were fewer side-effects after PP-treatment (p ＜ 0.0001). Conclusion Although the high acquisition cost of PP has been regarded as an obstacle to its clinical use, our results imply that the high prescription costs for PP may be counterbalanced by the reduced admission costs associated with its use. Economic outcomes for patients treated with LAIs should be investigated further to help healthcare decision-makers and providers to determine the value of LAIs relative to other treatment medications.