Purpose: The risk of suicide is approximately two times higher in patients with breast cancer compared to the general population. Suicide risk factors are widely investigated but research on the protective factors is lacking. We investigated whether each subscale of grit, consistency of interest, and perseverance of effort, could serve as a protective factor against suicidality. Materials and Methods: Participants were recruited at the Stress Clinic for Cancer Patients, a psycho-oncology clinic at Asan Medical Center from May 2019 to March 2021. A total of 140 female patients with breast cancer completed self-administered questionnaires including Grit scale, Distress thermometer, and Mini International Neuropsychiatric Interview (MINI) suicidality module. We used PROCESS macro for analyzing the mediation model to identify the protective factors for suicidality. Results: Our findings showed that perseverance of effort showed statistically non-significant associations with psychological distress (p=0.403) and suicidality (p=0.945), however, consistency of interest decreased suicidality through psychological distress (β=–0.015; 95% confidence interval, –0.035 to –0.002). Conclusion The result shows that consistency of interest can be a protective factor against suicidality by reducing psychological distress.

Purpose: The risk of suicide is approximately two times higher in patients with breast cancer compared to the general population. Suicide risk factors are widely investigated but research on the protective factors is lacking. We investigated whether each subscale of grit, consistency of interest, and perseverance of effort, could serve as a protective factor against suicidality. Materials and Methods: Participants were recruited at the Stress Clinic for Cancer Patients, a psycho-oncology clinic at Asan Medical Center from May 2019 to March 2021. A total of 140 female patients with breast cancer completed self-administered questionnaires including Grit scale, Distress thermometer, and Mini International Neuropsychiatric Interview (MINI) suicidality module. We used PROCESS macro for analyzing the mediation model to identify the protective factors for suicidality. Results: Our findings showed that perseverance of effort showed statistically non-significant associations with psychological distress (p=0.403) and suicidality (p=0.945), however, consistency of interest decreased suicidality through psychological distress (β=–0.015; 95% confidence interval, –0.035 to –0.002). Conclusion The result shows that consistency of interest can be a protective factor against suicidality by reducing psychological distress.

Purpose: The risk of suicide is approximately two times higher in patients with breast cancer compared to the general population. Suicide risk factors are widely investigated but research on the protective factors is lacking. We investigated whether each subscale of grit, consistency of interest, and perseverance of effort, could serve as a protective factor against suicidality. Materials and Methods: Participants were recruited at the Stress Clinic for Cancer Patients, a psycho-oncology clinic at Asan Medical Center from May 2019 to March 2021. A total of 140 female patients with breast cancer completed self-administered questionnaires including Grit scale, Distress thermometer, and Mini International Neuropsychiatric Interview (MINI) suicidality module. We used PROCESS macro for analyzing the mediation model to identify the protective factors for suicidality. Results: Our findings showed that perseverance of effort showed statistically non-significant associations with psychological distress (p=0.403) and suicidality (p=0.945), however, consistency of interest decreased suicidality through psychological distress (β=–0.015; 95% confidence interval, –0.035 to –0.002). Conclusion The result shows that consistency of interest can be a protective factor against suicidality by reducing psychological distress.

Objective: We aimed to determine the overall profile of patients in a psycho-oncology clinic and the differences in their characteristics according to the cancer site. Methods: The charts of 740 patients aged under 81 years were reviewed. The data from 586 completed questionnaires were subjected to multiple comparison analyses using one-way analysis of variance to examine the demographic and clinical differences according to the cancer site. Results: Most (n=532, 71.9%) patients were referred. Most new patients (n=426, 96.6%) received a psychiatric diagnosis; the most common diagnosis was depressive disorder (n=234, 31.6%). Likewise, depressive disorder accounted for the majority of diagnoses in all groups except for the digestive system cancer group in which sleep-wake disorder was the most prevalent. The female genital cancer group showed a higher level of anxiety symptoms than other groups, except for breast and haematolymphoid cancer groups, and psychological distress than all other groups. Conclusion There appear to be delays in the referral of cancer patients seeking psychiatric help to a psycho-oncology clinic. Along with tailoring approaches by cancer site, thorough evaluation and appropriate management of sleep-wake and anxiety symptoms are important for digestive system and female genital cancer patients, respectively.

Objective: We aimed to determine the overall profile of patients in a psycho-oncology clinic and the differences in their characteristics according to the cancer site. Methods: The charts of 740 patients aged under 81 years were reviewed. The data from 586 completed questionnaires were subjected to multiple comparison analyses using one-way analysis of variance to examine the demographic and clinical differences according to the cancer site. Results: Most (n=532, 71.9%) patients were referred. Most new patients (n=426, 96.6%) received a psychiatric diagnosis; the most common diagnosis was depressive disorder (n=234, 31.6%). Likewise, depressive disorder accounted for the majority of diagnoses in all groups except for the digestive system cancer group in which sleep-wake disorder was the most prevalent. The female genital cancer group showed a higher level of anxiety symptoms than other groups, except for breast and haematolymphoid cancer groups, and psychological distress than all other groups. Conclusion There appear to be delays in the referral of cancer patients seeking psychiatric help to a psycho-oncology clinic. Along with tailoring approaches by cancer site, thorough evaluation and appropriate management of sleep-wake and anxiety symptoms are important for digestive system and female genital cancer patients, respectively.

Occurrence of carbon monoxide intoxication has decreased due to decline in use of coal briquettes (anthracite) in Korea. However, suicide attempt by use of a coal fire lighter (beon-gae-tan) has shown a rapid increase over the past five years with relevance to imitated suicide. Acute carbon monoxide intoxication is a dangerous problem affecting the brain, kidney, lung, and other major organs. Sometimes, delayed encephalopathy after carbon monoxide intoxication makes clinical psychiatric diagnosis and treatment puzzling because neuropsychiatric sequelae are ambiguous with premorbid psychiatric problems, such as mood disorder, psychotic disorder, or other substance dependence. We report on a case of delayed encephalopathy of carbon monoxide intoxication and discuss its diagnosis and management.
Affective Disorders, Psychotic ; Brain ; Carbon Monoxide* ; Carbon* ; Coal ; Diagnosis ; Fires ; Kidney ; Korea ; Lung ; Mental Disorders ; Substance-Related Disorders ; Suicide

Purpose: The characteristics of suicidal ideation among psycho-oncology outpatients remain unexplored. This study determined the prevalence and risk factors of suicidal ideation among patients in a psycho-oncology outpatient clinic. Materials and Methods: The prevalence of suicidal ideation during the previous 2 weeks among 545 psycho-oncology outpatients aged 80 years or below was determined using the Patient Health Questionnaire-9 Item 9. Descriptive analyses, including the prevalence of suicidal ideation, were performed. After multiple imputation, multivariable logistic regression was performed using demographic and clinical variables and functional (the Functional Assessment of Cancer Therapy–General) and emotional status (the Hospital Anxiety and Depression Scale and the distress thermometer). Results: There were 252 (46.2%) suicidal ideators. After adjusting for sex and age, active disease [odds ratio (OR)=1.708, 95% confidence interval (CI)=1.049–2.780], lower levels of physical (OR=0.948, 95% CI=0.905–0.992) and emotional well-being (OR=0.925, 95% CI=0.875–0.978), and higher degrees of depressive symptoms (OR=1.126, 95% CI=1.036–1.224) and psychological distress (OR=1.201, 95% CI=1.071–1.347) were associated with suicidal ideation. Conclusion Approximately half of the psycho-oncology outpatients experienced suicidal ideation, emphasizing the importance of identifying and understanding the risk factors of suicidal ideation specific to this group. For those who are under active cancer treatment, show poorer physical and emotional well-being, and report more severe depressive symptoms and psychological distress, a thorough evaluation of suicidal ideation needs to be performed.

Objective: In this study, we aimed to develop a Korean version of the Coronavirus Reassurance-Seeking Behaviors Scale (CRBS) and to explore its reliability and validity among the general population in South Korea. Methods: Using an online survey conducted during November 9–15, 2021, we collected the demographic data of 400 individuals and their responses to rating scales such as the CRBS, the Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), the Generalized Anxiety Disorder-7 items (GAD-7), and the Patient Health Questionnaire-9 items (PHQ-9). We conducted factor analyses and utilized item response theory to confirm the validity and reliability of the Korean version of the CRBS. Results: Factor analyses revealed that the single factor model of the Korean version of the CRBS showed a good fit with the CRBS (χ2=5.475, df=5, p value=0.361, χ2/df=1.095, CFI=0.999, TLI=0.998, RMSEA=0.015). Multigroup CFA results indicated that the CRBS measures reassurance-seeking behaviors consistently across variables of sex, depression, general anxiety, and viral anxiety. The CRBS also exhibited good convergent validity with the SAVE-6 (r=0.431, p<0.001), GAD-7 (r=0.574, p<0.001), and PHQ-9 (r=0.575, p<0.001). Conclusion The CRBS is a reliable and valid rating scale that measures reassurance-seeking behavior in relation to viral epidemics.

Objective: This study aims to explore the association between work-related stress of healthcare workers in response to the coronavirus disease-2019 (COVID-19) pandemic and their depressive symptoms. Additionally, it focuses on the impact of insomnia symptoms, interpersonal factors, and resilience on depressive symptoms. Methods: The results of an anonymous survey of 329 healthcare workers were analyzed, including the Stress and Anxiety to Viral Epidemics-3 items, Insomnia Severity Index, Interpersonal Needs Questionnaire, Connor–Davidson Resilience Scale-2 items, and Patient Health Questionnaire-9 items. Mediation analysis assessed whether insomnia symptoms, resilience, and interpersonal factors mediate the association between work-related stress and depressive symptoms. Results: Work-related stress directly influenced depressive symptoms (standardized estimator=0.11, p=0.010, 95% confidence interval [CI] 0.03–0.19). The association between the former and latter was positively mediated by insomnia symptoms (standardized estimator=0.10, p<0.001, 95% CI 0.05–0.14), thwarted belongingness (standardized estimator=0.04, p=0.006, 95% CI 0.01–0.07), and perceived burdensomeness (standardized estimator=0.05, p=0.002, 95% CI 0.02–0.08) and was negatively mediated by resilience (standardized estimator=0.02, p=0.041, 95% CI 0.0001–0.04). Conclusion This study highlights the connection between heightened work-related stress experienced by healthcare workers amid the COVID-19 pandemic and the subsequent development of depressive symptoms mediated by insomnia, interpersonal factors, and resilience. Interventions that focus on building resilience could be pivotal in mitigating the detrimental mental health consequences of workplace stress among healthcare workers in a viral epidemic.

Objective: This study aims to explore the association between work-related stress of healthcare workers in response to the coronavirus disease-2019 (COVID-19) pandemic and their depressive symptoms. Additionally, it focuses on the impact of insomnia symptoms, interpersonal factors, and resilience on depressive symptoms. Methods: The results of an anonymous survey of 329 healthcare workers were analyzed, including the Stress and Anxiety to Viral Epidemics-3 items, Insomnia Severity Index, Interpersonal Needs Questionnaire, Connor–Davidson Resilience Scale-2 items, and Patient Health Questionnaire-9 items. Mediation analysis assessed whether insomnia symptoms, resilience, and interpersonal factors mediate the association between work-related stress and depressive symptoms. Results: Work-related stress directly influenced depressive symptoms (standardized estimator=0.11, p=0.010, 95% confidence interval [CI] 0.03–0.19). The association between the former and latter was positively mediated by insomnia symptoms (standardized estimator=0.10, p<0.001, 95% CI 0.05–0.14), thwarted belongingness (standardized estimator=0.04, p=0.006, 95% CI 0.01–0.07), and perceived burdensomeness (standardized estimator=0.05, p=0.002, 95% CI 0.02–0.08) and was negatively mediated by resilience (standardized estimator=0.02, p=0.041, 95% CI 0.0001–0.04). Conclusion This study highlights the connection between heightened work-related stress experienced by healthcare workers amid the COVID-19 pandemic and the subsequent development of depressive symptoms mediated by insomnia, interpersonal factors, and resilience. Interventions that focus on building resilience could be pivotal in mitigating the detrimental mental health consequences of workplace stress among healthcare workers in a viral epidemic.