BACKGROUND: To further understand the relationship between anxiety and depression, this study examined the factor structure of the combined items from two validated measures for anxiety and depression. METHODS: The participants were 406 patients with mixed psychiatric diagnoses including anxiety and depressive disorders from a psychiatric outpatient unit at a university-affiliated medical center. Responses of the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI)-II, and Symptom Checklist-90-Revised (SCL-90-R) were analyzed. We conducted an exploratory factor analysis of 42 items from the BAI and BDI-II. Correlational analyses were performed between subscale scores of the SCL-90-R and factors derived from the factor analysis. Scores of individual items of the BAI and BDI-II were also compared between groups of anxiety disorder (n = 185) and depressive disorder (n = 123). RESULTS: Exploratory factor analysis revealed the following five factors explaining 56.2% of the total variance: somatic anxiety (factor 1), cognitive depression (factor 2), somatic depression (factor 3), subjective anxiety (factor 4), and autonomic anxiety (factor 5). The depression group had significantly higher scores for 12 items on the BDI while the anxiety group demonstrated higher scores for six items on the BAI. CONCLUSION: Our results suggest that anxiety and depressive symptoms as measured by the BAI and BDI-II can be empirically differentiated and that particularly items of the cognitive domain in depression and those of physical domain in anxiety are noteworthy.
Anxiety Disorders ; Anxiety* ; Depression* ; Depressive Disorder ; Diagnosis ; Factor Analysis, Statistical* ; Humans ; Outpatients*

OBJECTIVES: The aims of this study were to investigate the pattern of stress coping strategies and the effects of stress coping strategies on quality of life in patients with schizophrenia. METHODS: Stress coping strategies and quality of life were examined using Ways of Coping Checklist and Schizophrenia Quality of Life Scale for 98 patients with schizophrenia. Stress coping strategies were composed of problem-focused coping, social support seeking, emotion-focused coping, and wishful thinking. Among these, problem-focused coping and social support seeking were active coping strategies while emotion-focused coping and wishful thinking were passive coping strategies. Positive and Negative Syndrome Scale (PANSS) and Beck's Depression Inventory (BDI) were also administered. RESULTS: Active coping scores were higher than passive coping scores in patients with schizophrenia. Quality of life was higher in the active coping group compared to the passive coping group. Active coping usage was a significant predictor of higher quality of life even after controlling for gender, age, PANSS, and BDI scores. CONCLUSION: Patients with schizophrenia used more active coping strategies than passive coping strategies, which showed significant association with higher quality of life. A treatment program to provide education on use of active coping strategies in a proper and flexible way might contribute to enhanced quality of life in patients with schizophrenia.
Adaptation, Psychological ; Checklist ; Depression ; Education ; Humans ; Quality of Life* ; Schizophrenia* ; Stress, Psychological ; Thinking

The Illness Intrusiveness Rating Scale (IIRS) measures illness-induced disruptions to 13 domains of lifestyles, activities, and interests. A stable three-factor structure has been well documented; however, the cross-cultural validity of this scale needs to be tested. This study investigated the factor structure of the Korean version of IIRS in 712 outpatients at a university medical center. A predominant diagnosis of the patients was rheumatoid arthritis (47%). The Center for Epidemiological Studies-Depression Scale (CES-D), and Health Assessment Questionnaire (HAQ) were also administered. Exploratory Principal Component Analysis identified a two-factor structure, "Relationships and Personal Development (RPD)" and "Instrumen-tal", accounting for 57% of the variance. Confirmatory analyses extracted an identical factor structure. However, a goodness-of-the fit test failed to support two-factor solution (X2 =138.2, df=43, p<.001). Two factors had high internal consistency (RPD, alpha=.89; Instrumental, alpha=.75) and significantly correlated with scores of HAQ (RPD, r=.53, p<.001; Instrumental, .r=44, p<.001) and CES-D (RPD, .r=55, p<.001; Instrumental, .r=43, p<.001). These findings supported construct validity of the Korean version of IIRS, but did not support cross-cultural equivalence of the factor structure.
Adult ; Aged ; Asian Continental Ancestry Group ; *Cross-Cultural Comparison ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; *Sickness Impact Profile

OBJECTIVES: This study sought to determine ethnic difference in physical violence and to see if ethnicity is an independent predictor of violence by surveying eight Korean or Han ethnic elementary schools in Yanji city, China. A total of 2,316 school children from fourth through sixth grade participated the study. METHODS: Participants completed a questionnaire on sociodemographic background and experiences of physical violence during the previous year using the Conflict Tactics Scale. The history of physical violence was categorized as within the family, by peers, or by teachers. RESULTS: Han children reported significantly higher rates of physical abuse compared with Koreans (76.2% vs. 54.9%, chi2=116.12, df=1, p=<.001). Binary logistic regression analysis identified five risk factors for physical violence:(1) ethnic Han (odds ratio [OR]=3.01, 95% confidence interval [CI]=2.47-3.66), (2) boys (OR=2.76, 95% CI=2.28-3.36), (3) poor economic status (OR=1.69, 95% CI=1.17-2.42), (4) single or absent parents (OR=1.42, 95% CI=1.09-1.86), (5) interaction of fourth-graders with promotive or neutral opinions of corporal punishment (OR=2.41, 95% CI=1.86-3.13). Ethnicity remained an independent risk factor after other sociodemographic variables were controlled. CONCLUSION: These findings showed cross-cultural risk factors of child physical abuse, including ethnicity which previously identified as a factor in literature. This study particularly reports lower prevalence of physical violence in ethnic minority, Korean-Chinese, compared with the Han ethnic group. This result explained a special environment of Korean self-government district and the successful adaptation of the ethnic minority to the mainstream culture.
Asian Continental Ancestry Group* ; Child ; Child Abuse ; China ; Ethnic Groups ; Humans ; Logistic Models ; Parents ; Prevalence* ; Punishment ; Surveys and Questionnaires ; Risk Factors ; Violence*

OBJECTIVES: This study investigated the psychosocial factors and clinical symptoms related to the duration of untreated psychosis (DUP) in 35 consecutive first-episode inpatients with schizophrenia. METHODS: Data from 35 schizophrenic patients were obtained from two general psychiatric inpatient units at a university medical center. These data included scores from Index of Social Position (ISP), Positive and Negative Syndrome Scale (PANSS) and Symptom Checklist-90-Revised (SCL-90-R) as well as socio-demographic informations. RESULTS: Among socio-demographic variables, lower social position (r=.610, p<.001), male sex (r=.407, p=.015), and grew up in rural area (r=.335, p=.045) were significantly correlated with DUP. The interpersonal sensitivity of SCL-90-R was the only symptomatic variable significantly correlated with DUP (r=.379, p=.027). However, after controlling interactive effects of the variables, only lower social position and interpersonal sensitivity remained significant. Lower social position was more influential on DUP than interpersonal sensitivity in the multiple regression model. CONCLUSION: Both social and symptomatic factors independently influenced DUP in schizophrenic patients. Lower social position defined by education and occupation of patients or caretakers may reflect barriers to psychiatric services or poor identification of mental illness. This together with patients' subjective distress in interpersonal interactions may delay the intervention of psychiatric services.
Academic Medical Centers ; Education ; Humans ; Inpatients ; Male ; Occupations ; Psychology ; Psychotic Disorders* ; Schizophrenia*

OBJECTIVES: Experience of early childhood abuse elevates the risk of developing schizophrenia in later period of life, incidence of psychiatric comorbidity, symptomatic severity and complexity. In this context, we hypothesized that the pattern of psychotropic medication used would reflect this; those with childhood trauma will received more types and higher doses of psychotropic medication. METHODS: From our database of 102 outpatients diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) schizophrenia, we analyzed experiences of childhood trauma measured by the Childhood Trauma Questionnaire-Short Form and types and dose of prescribed psychotropic medication. RESULTS: We found significant positive correlations between child sexual abuse and the number of psychotropic medications (p = 0.029) and between child emotional neglect and the number of psychotropic medications other than antipsychotics (p = 0.045). CONCLUSIONS: This preliminary study suggests that the pattern of psychotropic use may be affected by types of childhood trauma. Further studies will have to shed light on mediating factors such as symptoms or comorbid conditions that lead to prescription of certain psychotropic class.
Antipsychotic Agents ; Child ; Child Abuse ; Child Abuse, Sexual ; Comorbidity ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Incidence ; Negotiating ; Outpatients ; Prescriptions ; Schizophrenia*

Background: Although the field of psychology currently recommends trauma-focused cognitive behavioral therapy for early psychological intervention for acute traumatic stress, additional research is required for safe and efficient psychotherapy that can delivered to a broader population and within a brief period of time. Methods: This pilot study examined the safety and feasibility of a single-session group stabilization intervention for individuals conducted at an average of two weeks after various types of traumatic events. Further development of DSM-5 mental disorders, such as post-traumatic stress disorder (PTSD) and others, was assessed at the six-month follow-up. A total of 38 participants with acute stress symptoms participated in a single-session 90-minute group psychotherapy, which consists of psychoeducation; identification of and coping with triggers; somatosensory grounding; and containment exercise. Results: After six months, follow-up was conducted on 34 (89.5%) patients, who completed the Structured Clinical Interview for DSM-5 Mental Disorders and the PTSD Checklist-5. One (2.9%) participant met the current diagnosis of PTSD, whereas none met any other psychiatric diagnoses. A significant decrease was noted in PTSD scores between baseline and follow-up (t=7.4, df=33, p<0.001, Cohen’s d=1.27) measured using the PTSD Checklist-5. Conclusion The finding suggests that a single stabilization session can be used in a safe and efficient manner at of the acute stage of trauma.

Objectives: ：This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods: ：A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results: ：The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions ：Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient- doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.

Purpose: Early intervention after trauma is needed for reduction in clinical distress and prevention of chronic posttraumatic stress disorder (PTSD). This study describes findings from an open pilot trial of a brief stabilization psychotherapy based on imagery techniques for adults with acute PTSD (i.e., within 3 months of onset). Materials and Methods: Four sessions of 60-minute individual psychotherapy were conducted on 18 participants with PTSD within 3 months after accidents, 15 of whom completed the treatment. The clinician-administered PTSD scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the Hamilton Depression and Anxiety Rating Scales, and self-questionnaires were administered at pre-treatment, post-treatment, and 6-month follow-up. Results: Eight (53.3%) of the 15 patients at post-treatment and 8 of the 9 patients at 6-month follow-up did not meet the DSM-5 criteria for PTSD. Reliable change of PTSD symptoms after treatment was observed in 6 of 15 (45.0%) patients at post-treatment and in 4 of 9 (45.0%) patients after 6 months. There was a significant decrease in PTSD, depression, anxiety, and impaired quality of life scores after treatment, and these gains were maintained after 6 months. No cases of exacerbated PTSD symptoms were observed among completers and non-completers. Conclusion Our findings suggest that brief stabilization sessions are safe treatment options for acute PTSD (KCT0001918).