1.Importance of connectedness for the management of embitterment and loneliness in the era of COVID-19
Journal of the Korean Medical Association 2021;64(6):394-399
Coronavirus disease 2019 (COVID-19) has made ‘untact’ life a new standard (next normal) way of life, minimizing physical contacts among people. Emotional exchanges between people are rapidly being replaced by contact through the Internet, social networks, and over-the-top services.Current Concepts: People are expressing more stress and anxiety that are caused by fear of infection, and also embitterment due to perceived distrust and injustice is increasing. In the era of COVID-19, it is necessary and important to manage burnout, depression, and anxiety symptoms of medical staff and quarantine personnel. The pandemic and the resulting social changes intensifies loneliness, leading to deterioration in mental and physical health. The World Health Organization has warned that loneliness and social isolation are leading to the exacerbation of physical illness and increased mortality due to suicide and other mental health problems.Discussion and Conclusion: It is needed to establish a next standard of mental health service such as untact diagnosis and follow-up support system. Government and society should establish a sustainable system even after the COVID-19 crisis, rather than stopgap measures made with people’s sacrifice as collateral.
2.Importance of connectedness for the management of embitterment and loneliness in the era of COVID-19
Journal of the Korean Medical Association 2021;64(6):394-399
Coronavirus disease 2019 (COVID-19) has made ‘untact’ life a new standard (next normal) way of life, minimizing physical contacts among people. Emotional exchanges between people are rapidly being replaced by contact through the Internet, social networks, and over-the-top services.Current Concepts: People are expressing more stress and anxiety that are caused by fear of infection, and also embitterment due to perceived distrust and injustice is increasing. In the era of COVID-19, it is necessary and important to manage burnout, depression, and anxiety symptoms of medical staff and quarantine personnel. The pandemic and the resulting social changes intensifies loneliness, leading to deterioration in mental and physical health. The World Health Organization has warned that loneliness and social isolation are leading to the exacerbation of physical illness and increased mortality due to suicide and other mental health problems.Discussion and Conclusion: It is needed to establish a next standard of mental health service such as untact diagnosis and follow-up support system. Government and society should establish a sustainable system even after the COVID-19 crisis, rather than stopgap measures made with people’s sacrifice as collateral.
3.Diagnosis and treatment of dementia in primary care.
Hyun Ghang JEONG ; Changsu HAN
Journal of the Korean Medical Association 2013;56(12):1104-1112
Dementia has became a major public health problem as the aged population is rapidly increasing. Dementia is underdiagnosed in primary care and many primary care physicians are hesitate to diagnose dementia. Early detection and starting appropriate treatment has been emphasized in managing dementia patients. The role of primary care physicians in caring for patients with demantia is important to efficiently manage dememtia and related socioeconomic burden since they meet first many patients mostly in initial stage of diseases. Primary care physicians pay attention to early sign and symptoms of dementia and are able to differentiate pathologic condition from normal age related cognitve decline. They should actively performe the screenig test and comprehensive clinical evaluation for suspected dementia patients. After diagnosis of dementia, they have to help thier patients to start and maintain appropriate pharmacological and non-pharmacological treatments and provide supports for dementia patients and their caregivers. To optimal management of dementia, primary care physicians also need to strengthen collaboration with specialists in treatment and lead their patients to utilize social servicies. It is necessary to develop systemized education programs for primary care physicians and standardized giudeline for maniging demenita in parimary care. Primary care physicians need to keep acquring up-to-date knowlege about dementia and to screen and detect dementia in suspected dementia patients. They should provide appropriate treatments for patinets in the collaboration with specialists and infrom their patients available social services.
Alzheimer Disease
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Caregivers
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Cooperative Behavior
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Dementia*
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Diagnosis*
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Education
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Humans
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Memory Disorders
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Physicians, Primary Care
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Primary Health Care*
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Public Health
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Social Work
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Specialization
4.A Study of Psychiatric Treatment Compliance in Referred Patients at a General Hospital.
In Bo SHIM ; Young Hoon KO ; Moon Soo LEE ; Yong Ku KIM ; Changsu HAN
Korean Journal of Psychosomatic Medicine 2011;19(2):66-73
OBJECTIVES: The present study investigates the status of inpatient psychiatric consultations at a general hospital in order to find factors that contribute to treatment compliance related to psychiatric consultations. METHODS: The subjects were 333 patients who were hospitalized at Korea University Medical Center Ansan Hospital from 1 September 2009 to 31 July 2010.The patients were referred for psychiatric consultation during hospitalization. This study investigates demographic data, request department, referral causes, requestor, psychiatric history and diagnosis, andpsychiatric treatment compliance. Treatment compliance was defined as whether or not the patient had accepted psychiatric treatment during hospitalization or outpatient department(OPD) follow-up. This study ascertains the factors that have impact on compliance, by taking binary logistic regression with compliance and other variables. RESULTS: Among the patients that were offered psychiatric treatment during hospitalization(N=310), treatment compliance was 82.9%. Among the patients that were offered OPD treatment(N=111), compliance was 55.8%. Elderly group(>65 years) showed better compliance to treatment during hospitalization than the younger patient group(OR=4.838, p=0.004). Patients with secondary psychiatric disorders showed better OPD follow-up compliance than patients with secondary psychiatric disorders(OR=8.520, p=.008). CONCLUSION: Elderly patients showed better compliance for psychiatric treatment during hospitalization. However they commonly have disorders such as delirium and mood disorders that have impact on the patient's physical state, hence further active measures should be carried out. Patients referred due to primary psychiatric disorders showed poor OPD compliance. Therefore clinicians have to suggest multidisciplinary interventions that will improve treatment compliance of such patients.
Academic Medical Centers
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Aged
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Compliance
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Delirium
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Follow-Up Studies
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Hospitalization
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Hospitals, General
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Humans
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Inpatients
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Korea
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Logistic Models
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Mood Disorders
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Outpatients
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Referral and Consultation
5.Pain and Depression: A Neurobiological Perspective of Their Relationship.
Psychiatry Investigation 2015;12(1):1-8
Remarkable progresses have been achieved regarding the understanding of the neurobiological bases of pain and depression. The principal role of neurotransmitters, neuromodulators, and neurohormones has been proposed in the development of pain and depression. With the progression of molecular biology, an intricate interaction among biological factors accountable to the development and management of pain and depression has been also shown in a numerous preclinical and clinical researches. This mini-review will briefly describe the current issues and future research direction for better understanding of the relationship between pain and depression.
Biological Factors
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Depression*
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Molecular Biology
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Neurotransmitter Agents
6.The Stress Perception, Depressive Symptoms and Medical Comorbidity in Healthcare Center.
In Bo SHIM ; Sook Haeng JOE ; Byung Joo HAM ; Changsu HAN ; Hyun Ghang JEONG ; Young Hoon KO
Korean Journal of Psychosomatic Medicine 2013;21(1):27-43
OBJECTIVES: We surveyed this study for knowing the relation within stress, depression and medical comorbidities, and finding the risk factors of major depression. METHODS: 1764 subjects were enrolled from Jan. 2009 to Dec. 2009 who visit Korea University Guro hospital healthcare center. The subjects answered the questionnaire of PSS(Perceived Stress Scale), PHQ-9(Patient Health Questionnaire-9) and the demographic data. We categorized them as the stress group, depressive group, medical comorbidity group and analyzed the correlation analyses and logistic regression analyses. RESULTS: 198 of 1764 subjects(11.8%) were applied to major depression, and the depressive group showed the higher mean stress score(23.19) and mean depression score(12.95) than the normal group. The total PHQ-9 score was increased by perceiving more stress, having more medical comorbidities. The subjects with female, visiting due to recent health problems, irregular exercise, current smoking, history of angina and cerebrovascular disease showed the increased risk of major depression. CONCLUSIONS: In this study, we find the PSS, PHQ-9 were valuable for mental health screening in healthcare center. As perceiving more stress and having more medical comorbidity, risk of major depression were increased. Accordingly the individuals with medical diseases or unhealthy lifestyle would need the mental health screen.
Comorbidity
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Delivery of Health Care
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Depression
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Female
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Humans
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Korea
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Life Style
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Logistic Models
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Mass Screening
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Mental Health
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Questionnaires
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Risk Factors
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Smoke
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Smoking
7.How to approach to suicide prevention
Journal of the Korean Medical Association 2019;62(2):79-84
In early 2018, the National Action Plan for Preventing Suicide was announced by the Ministry of Health and Welfare and related ministries. The Action Plan presents a realistic goal of reducing suicide mortality to two-thirds of the present level, which would make it 1.4 times higher than the Organization for Economic Cooperation and Development average (in contrast to current circumstances, in which it is 2.4 times higher than the Organization for Economic Cooperation and Development average). Several public and private organizations are engaged in various suicide prevention activities. However, it is crucial for a seamless network to be formed, including government organizations, medical institutions, private organizations, and religious organizations. In medical settings, it is imperative that clinicians assess patients' risk of depression or suicide and arrange for a referral service. We need to connect modern social trends with classical mental health treatment modalities by using technologies such as smartphones and the internet. Strategies for research and development and for actual implementation must be established. Suicide prevention requires the active cooperation of not only mental health professionals, but also all physicians and health professionals. Experts in philosophy, sociology, economics, religion, and anthropology must also collaborate to find ways of affirming the importance of human life.
8.How to approach to suicide prevention
Journal of the Korean Medical Association 2019;62(2):79-84
In early 2018, the National Action Plan for Preventing Suicide was announced by the Ministry of Health and Welfare and related ministries. The Action Plan presents a realistic goal of reducing suicide mortality to two-thirds of the present level, which would make it 1.4 times higher than the Organization for Economic Cooperation and Development average (in contrast to current circumstances, in which it is 2.4 times higher than the Organization for Economic Cooperation and Development average). Several public and private organizations are engaged in various suicide prevention activities. However, it is crucial for a seamless network to be formed, including government organizations, medical institutions, private organizations, and religious organizations. In medical settings, it is imperative that clinicians assess patients' risk of depression or suicide and arrange for a referral service. We need to connect modern social trends with classical mental health treatment modalities by using technologies such as smartphones and the internet. Strategies for research and development and for actual implementation must be established. Suicide prevention requires the active cooperation of not only mental health professionals, but also all physicians and health professionals. Experts in philosophy, sociology, economics, religion, and anthropology must also collaborate to find ways of affirming the importance of human life.
Anthropology
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Depression
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Health Occupations
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Humans
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Internet
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Loneliness
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Mental Health
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Mortality
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Organisation for Economic Co-Operation and Development
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Philosophy
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Referral and Consultation
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Smartphone
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Sociology
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Suicide
9.Tools for Quality Evaluation of Clinical Research Reports.
Cheolmin SHIN ; Changsu HAN ; Chi Un PAE ; Ashwin A PATKAR
Korean Journal of Psychopharmacology 2011;22(2):67-72
Quality of medical research reports should be evaluated before they are applied to clinical practice. Since 1990s, several guidelines on research reports were suggested. Most recently published Consolidated Standards of Reporting Trials statement 2010 consists of 25 checklists and flow diagram for reporting an randomized controlled trial. Strengthening the reporting of observational studies in epidemiology statement is a checklist of items that should be addressed in articles reporting on the observational studies in epidemiology. TREND statement for the reporting of nonrandomized designs consists of 22 checklists. The Quality of Reporting of Meta-analyses checklist proposes to provide checklist and flow diagram for reporting of meta-analyses. The Meta-analysis of Observational Studies in Epidemiology statement proposes a checklist for compensating the study errors about observational studies in epidemiology. After development of reporting guidelines, improvements in the quality of reports are continuously reported, so using guidelines in the medical research will be expected to be more generalized.
Checklist
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Meta-Analysis as Topic
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Research Report
10.The Reliability and Validity Studies of the Korean Version of the Perceived Stress Scale.
Jongha LEE ; Cheolmin SHIN ; Young Hoon KO ; Jaehyung LIM ; Sook Haeng JOE ; Seunghyun KIM ; In Kwa JUNG ; Changsu HAN
Korean Journal of Psychosomatic Medicine 2012;20(2):127-134
OBJECTIVES: Perceived stress scale is a self-report inventory to estimate the degree of individual perceived stress in daily life. The aim of this study was to introduce this scale and test the reliability and validity of the Korean version of PSS. METHODS: The total of 154 female hospital workers were included in this study. The survey questionnaires were conducted for demographic information. All participants were required to complete PSS, Hamilton Anxiety scale and Beck Depression Inventory. Reliability and validity studies were conducted and internal consistency was examined. RESULTS: The mean score of the PSS reported in this sample was 20.69+/-4.56. The overall Cronbach's alpha was 0.819, and the test-retest reliability coefficient was 0.66. PSS had a significant positive correlation with the HAM-A(r=0.49, p<0.01), and the BDI(r=0.55, p<0.01). Factor analysis yielded 2 factors with eigenvalues of 3.924 and 2.608, accounting for 65 percent of variance. Factor 1 represented "stress" and factor 2 represented "control of stress". CONCLUSIONS: This study indicates that the PSS is appropriate for estimating the perceived stress levels. These results support the use of PSS in large sections of the population in Korea.
Accounting
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Anxiety
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Depression
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Female
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Humans
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Korea
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Questionnaires
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Reproducibility of Results