1.A Study on the Characteristics of Intentional Self-Poisoning Patients :Comparison between Non-Prescription and Prescription Drugs
Eulah CHO ; Ji Hyun CHO ; Kyeng Hyeng JHO ; Hyun-Bo SIM
Korean Journal of Psychosomatic Medicine 2020;28(2):116-125
Objectives:
:Self-poisoning is the leading cause of visits to the emergency departments after a suicide attempts. This study is aimed to compare the patient characteristics according to the category of drugs ingested by the patients who attempted suicide.
Methods:
:All medical charts were retrospectively reviewed from patients who visited the emergency center, at Seoul Medical Center, due to intentional self-poisoning from April of 2011 to July of 2019. We investigated the information regarding the subtype and quantity of the intoxication drug, how it was obtained, suicidal history, and psychiatric history, as well as, sociodemographic information. Variables were compared between prescription drug (PD) and non-prescription drug (NPD) poisoning groups.
Results:
:The mean age of the NPD poisoning group was significantly lower than that of the PD poisoning group. The patient ratio of those enrolled in national health insurance and living with spouses were significantly higher in the NPD poisoning group. Compared to the NPD poisoning group, the PD poisoning group had a higher incidence of mental illnesses, underlying diseases and ratio of involuntary visit to the emergency department.Among the prescription drugs, the benzodiazepine poisoning group had a higher rate of self-prescription than the non-poisoning group, while the zolpidem poisoning group had a higher rate of the using someone else’s prescription than other drugs. Each single drug poisoning group (benzodiazepine, zolpidem, and antidepressant singleagent) had a higher rate of no mental illness than each of the mixed-poisoning group.
Conclusions
:Guidelines for regulating non-prescription drugs are needed as a matter of suicide prevention. Also, this study suggests that clinicians need to be careful when issuing prescriptions and should suicidal risk according to patients’ characteristics, duration of follow-up and type of drug packaging.
2.A Study on the Characteristics of Intentional Self-Poisoning Patients :Comparison between Non-Prescription and Prescription Drugs
Eulah CHO ; Ji Hyun CHO ; Kyeng Hyeng JHO ; Hyun-Bo SIM
Korean Journal of Psychosomatic Medicine 2020;28(2):116-125
Objectives:
:Self-poisoning is the leading cause of visits to the emergency departments after a suicide attempts. This study is aimed to compare the patient characteristics according to the category of drugs ingested by the patients who attempted suicide.
Methods:
:All medical charts were retrospectively reviewed from patients who visited the emergency center, at Seoul Medical Center, due to intentional self-poisoning from April of 2011 to July of 2019. We investigated the information regarding the subtype and quantity of the intoxication drug, how it was obtained, suicidal history, and psychiatric history, as well as, sociodemographic information. Variables were compared between prescription drug (PD) and non-prescription drug (NPD) poisoning groups.
Results:
:The mean age of the NPD poisoning group was significantly lower than that of the PD poisoning group. The patient ratio of those enrolled in national health insurance and living with spouses were significantly higher in the NPD poisoning group. Compared to the NPD poisoning group, the PD poisoning group had a higher incidence of mental illnesses, underlying diseases and ratio of involuntary visit to the emergency department.Among the prescription drugs, the benzodiazepine poisoning group had a higher rate of self-prescription than the non-poisoning group, while the zolpidem poisoning group had a higher rate of the using someone else’s prescription than other drugs. Each single drug poisoning group (benzodiazepine, zolpidem, and antidepressant singleagent) had a higher rate of no mental illness than each of the mixed-poisoning group.
Conclusions
:Guidelines for regulating non-prescription drugs are needed as a matter of suicide prevention. Also, this study suggests that clinicians need to be careful when issuing prescriptions and should suicidal risk according to patients’ characteristics, duration of follow-up and type of drug packaging.
3.Mediating Role of Viral Anxiety and Insomnia in Relationship Between Work-Related Stress and Depression Among Cold Chain Workers During COVID-19 Pandemic
Du XINJIE ; He RUNLIAN ; Oli AHMED ; Eulah CHO ; Seockhoon CHUNG
Journal of Korean Medical Science 2023;38(43):e338-
Background:
Here we investigated whether cold chain workers’ insomnia, work-related stress, and viral anxiety contributed to their depression. Furthermore, we investigated the role of viral anxiety in mediating the association between work-related stress and depressive symptoms.
Methods:
All 200 invited cold chain workers voluntarily responded to an online survey. All were working at a market in Taiyuan, Shanxi Province, China, and responsible for testing nucleic acids in imported cold chain foods and disinfecting outer packaging at government request. We collected their demographic variables and rated their symptoms using the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6), Patient Health Questionnaire-9, Insomnia Severity Index (ISI), Perceived Stress Scale (PSS), and Maslach Burnout Inventory - General Survey (MBI-GS).
Results:
Cold chain workers’ depression was significantly correlated with higher SAVE-6 (r = 0.450, P < 0.01), ISI (r = 0.603, P < 0.01), MBI-GS (r = 0.481, P < 0.01), and PSS (r = 0.390, P < 0.01) scores. SAVE-6 score was significantly correlated with ISI (r = 0.462, P < 0.01), MBI-GS (r = 0.305, P < 0.01), and PSS (r = 0.268, P < 0.01) scores. Linear regression revealed that their depression was predicted by SAVE-6 (β = 0.183, P = 0.003), ISI (β = 0.409, P < 0.001), and MBI-GS (β = 0.236, P = 0.002, adjusted R2 = 0.440, F = 40.04, P < 0.001) scores. Mediation analysis showed that their burnout directly influenced their depression, while viral anxiety or insomnia severity mediated the influence of burnout on depression.
Conclusion
The study showed that burnout was a direct cause of depression and that viral anxiety and insomnia severity mediated the relationship between burnout and depression.
4.Intolerance of Uncertainty Mediates the Influence of Viral Anxiety on Social Distancing Phobia Among the General Korean Population During the Coronavirus Disease 2019 Pandemic
Inn-Kyu CHO ; Oli AHMED ; Dongin LEE ; Eulah CHO ; Seockhoon CHUNG ; Aykut GÜNLÜ
Psychiatry Investigation 2022;19(9):712-721
Objective:
We aimed to examined the reliability and validity of Korean version of Social Distancing Phobia scale, and whether intolerance of uncertainty mediates the association of the general population’s social distancing phobia with viral anxiety and depression.
Methods:
Through this anonymous online survey, we collected responses from 400 individuals in the general Korean population. Participants’ demographic information and rating scales scores, including the Social Distancing Phobia scale, Stress and Anxiety to Viral Epidemics-6 items, Patient Health Questionnaire-9, and Intolerance of Uncertainty-12 items.
Results:
Confirmatory factor analysis showed a good model fit, and the Korean version of Social Distancing Phobia scale showed good internal consistency. Social distancing phobia was significantly correlated with age (r=0.213, p<0.001), viral anxiety (r=0.390, p<0.001), depression (r=0.244, p<0.001), and intolerance of uncertainty (r=0.323, p<0.001). A linear regression analysis showed that age (β=0.235, p<0.001), viral anxiety (β=0.281, p<0.001), depression (β=0.121, p=0.009), and intolerance of uncertainty (β=0.200, p<0.001; adjusted R2=0.246, F=33.6, p<0.001) predicted social distancing phobia. Mediation analysis revealed that viral anxiety directly influenced social distancing phobia (z=6.48, p<0.001), and intolerance of uncertainty partially mediated this association (z=2.92, p=0.003).
Conclusion
Social distancing phobia may cause psychological stress but may also increase adherence to physical distancing measures and prevent the spread of viruses.
5.A study of factors influencing the length of stay in the emergency department of patients who were admitted after a self-poisoning suicidal attempt
Ganggi LEE ; Eulah CHO ; Ji Hyun CHO ; Hyun-Bo SIM ; Jinhyung PARK ; Chang Hae PYO ; Hyun Kyung PARK ; Keunhong PARK
Journal of the Korean Society of Emergency Medicine 2021;32(6):647-656
Objective:
A suicide attempt by self-poisoning is a common cause of admissions to the emergency department (ED). Management of such intentiona poisoning often requires complicated medical procedures, resulting in a longer length of stay (LOS) as compared to other cases that require treatment in the ED. This study aimed to determine the factors affecting a longer LOS in self-poisoning patients.
Methods:
This was a retrospective study wherein all the medical charts of patients who visited the ED of one hospital, from August 2016 to July 2019, because of intentional self-poisoning, were reviewed.
Results:
Most of the patients visited the ED involuntarily and there were almost twice as many female patients as males. Almost half of the patients were referred to the psychiatry department. A comparison of various factors within the LOS groups revealed significant differences in mental status, guardian co-visitation, patient gender, psychiatric referral, and poisoning substance. Moreover, the LOS had a stronger association with the pre-consultation period than the consultation to decision-making period.
Conclusion
To reduce the LOS, it seems important to make a rapid decision on whether to observe the patient in the ED and wait until the workup is completed or to admit and then evaluate the patient in the ward. If the clinicians cannot obtain enough information to evaluate the patient for appropriate management, short-term admission may be an option to reduce the LOS and to provide a stable evaluation.
6.Mediating Effect of Intolerance of Uncertainty and Cancer-Related Dysfunctional Beliefs About Sleep on Psychological Symptoms and Fear of Progression Among Cancer Patients
Jaeeun SONG ; Eulah CHO ; Inn-Kyu CHO ; Dongin LEE ; Jiyoung KIM ; Harin KIM ; Seockhoon CHUNG
Psychiatry Investigation 2023;20(10):912-920
Objective:
This study aimed to explore the mediating effects of cancer-related dysfunctional beliefs regarding sleep and intolerance of uncertainty on the effect of depression, insomnia, and anxiety on fear of progression (FoP).
Methods:
We retrospectively reviewed medical records of patients with cancer who visited the Sleep Clinic for cancer patients in Asan Medical Center for the first time between December 2021 and March 2022. Data collected included age, sex, types of cancer, staging, current treatment modalities, and history of surgical procedures. In addition, psychological symptoms were rated using the Insomnia Severity Scale (ISI), Patient Health Questionnaire–9 items (PHQ-9), State subcategory of the State and Trait of Anxiety Inventory (STAI-S), Short form of Fear of Progression Questionnaire, Cancer-related Dysfunctional Beliefs about Sleep scale (C-DBS), single item of pain and fatigue, Connor Davidson Resilience Scale 2-item (CD-RISC2), and Intolerance of Uncertainty–12 (IUS-12). The predictive variables for FoP were determined by linear regression analysis.
Results:
The FoP was significantly correlated with age (r=-0.289), ISI (r=0.178), PHQ-9 (r=0.703), STAI-S (r=0.377), fatigue (r=0.452), CD-RISC2 (r=-0.270), IUS-12 (r=0.585), and C-DBS (r=0.427, all p<0.01). A mediation analysis showed that intolerance of uncertainty and dysfunctional beliefs about sleep mediated the relationship of FoP with insomnia, depression, or anxiety.
Conclusion
Psychological support for intolerance of uncertainty and cancer-related dysfunctional beliefs about sleep in patients with cancer may be beneficial to reduce their FoP.
7.Changes in Insomnia Severity are Associated With the Changes in Discrepancy Between Desired Time in Bed and Desired Total Sleep Time Among the General Population
Seockhoon CHUNG ; Sohyeong KIM ; Inn-Kyu CHO ; Dongin LEE ; Jiyoung KIM ; Eulah CHO
Psychiatry Investigation 2023;20(12):1148-1156
Objective:
The discrepancy between desired time in bed and desired total sleep time (DBST index) is correlated with the severity of insomnia among the general population. This study aimed to explore whether the change in DBST index is associated with changes in insomnia severity.
Methods:
The study was conducted as a single source tracking online survey among the general population. The first survey (T1) was completed by all 399 participants, and the second survey (T2) was completed by 233 participants 5–6 weeks after the T1 survey with a simple instruction of reducing the DBST index. Participants’ age, sex, marital status, past psychiatric history, and sleep patterns were collected. In addition to the DBST index, the Glasgow Sleep Effort Scale (GSES), Dysfunctional Beliefs about Sleep-2 items (DBS-2), and Insomnia Severity Index (ISI) were rated.
Results:
The change in the ISI (T1–T2) was significantly correlated with the changes in the GSES (r=0.24, p<0.001), DBS-2 (r=0.22, p<0.001), and DBST index (r=0.15, p=0.020). The change in insomnia severity was expected with change in the GSES (β=0.23, p<0.001), DBS-2 (β=0.20, p=0.002), and DBST index (β=0.13, p=0.037). Mediation analysis showed that change in DBST index directly influenced change in insomnia severity and change in GSES or DBS-2 did not mediate the relationship.
Conclusion
Changing the DBST index can be a simple way to reduce insomnia severity among the general population.
8.Application of Stress and Anxiety to Viral Epidemics-6 to Measure the Anxiety Response of Cold Chain Practitioners During the COVID-19 Post-Pandemic Era in China
He RUNLIAN ; Du XINJIE ; Oli AHMED ; Eulah CHO ; Seockhoon CHUNG
Psychiatry Investigation 2023;20(2):75-83
Objective:
This study explored the psychometric properties of the Chinese version of the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6) scale for cold chain practitioners exposed to moderate-to-high risk of infection.
Methods:
A total of 233 cold chain practitioners participated in an anonymous online survey, conducted from October to November 2021. The questionnaire comprised participant demographic characteristics, the Chinese version of SAVE-6, the Generalized Anxiety Disorders-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9) scales.
Results:
Based on the results of the parallel analysis, the single-structure model of the Chinese version of SAVE-6 was adopted. The scale showed satisfactory internal consistency (Cronbach’s alpha=0.930) and good convergent validity based on Spearman’s correlation coefficient with the GAD-7 (rho=0.616, p<0.001) and PHQ-9 (rho=0.540, p<0.001) scale scores. The optimal cutoff score for Chinese Stress and Anxiety to Viral Epidemics-9 Items was identified as ≥12 (area under the curve=0.797, Sensitivity=0.76, Specificity=0.66) for cold chain practitioners.
Conclusion
The Chinese version of the SAVE-6 scale has good psychometric properties and can be applied as a reliable and valid rating scale to assess the anxiety response of cold chain practitioners in the post-pandemic era.
9.Effect of Cancer-Related Dysfunctional Beliefs About Sleep on Fear of Cancer Progression in the Coronavirus Pandemic
Harin KIM ; Inn-Kyu CHO ; Dongin LEE ; Kyumin KIM ; Joohee LEE ; Eulah CHO ; C. Hyung Keun PARK ; Seockhoon CHUNG
Journal of Korean Medical Science 2022;37(36):e272-
Background:
This study aimed to explore clinical correlates of fear of progression (FoP) among patients with cancer during the coronavirus disease 2019 (COVID-19) pandemic and examine the mediation effect of cancer-related dysfunctional beliefs about sleep (C-DBS).
Methods:
Medical charts of patients with cancer who visited a psycho-oncology clinic between July and November 2021 were reviewed. Baseline socio-demographic and cancer-related variables were collected. Patients’ self-report questionnaires, regarding FoP, depression (Patient Health Questionnaire-9 items; PHQ-9), viral anxiety (Stress and Anxiety to Viral Epidemics-6 items; SAVE-6), C-DBS, and other distress, were investigated. Pearson’s correlation and linear regression were performed to examine the risk factors of FoP. Mediation effect analysis with the bootstrap method with 2,000 resamples was implemented.
Results:
A total of 231 patients were included in the analysis. Linear regression revealed that FoP was predicted by age (β = −0.14, P = 0.003), PHQ-9 (β = 0.48, P < 0.001), SAVE-6 (β = 0.34, P < 0.001), and C-DBS (β = 0.15, P = 0.005). FoP was directly influenced by SAVE-6 and mediated by C-DBS, while it was directly influenced by PHQ-9 with no mediation effect.
Conclusion
During the COVID-19 pandemic, the FoP of patients with cancer was associated with younger age, depression, viral anxiety, and C-DBS. Depression and viral anxiety directly influenced FoP, while C-DBS mediated the association between viral anxiety and FoP.Therefore, oncology healthcare professionals are recommended to assess C-DBS of their patients when they are highly distressed from FoP.
10.Assessing Stress and Anxiety in Firefighters During the Coronavirus Disease-2019 Pandemic: A Comparative Adaptation of the Stress and Anxiety in the Viral Epidemic–9 Items and Stress and Anxiety in the Viral Epidemics–6 Items Scales
Inn-Kyu CHO ; Han Sung LEE ; Kayoung SONG ; Oli AHMED ; Dongin LEE ; Jiyoung KIM ; Eulah CHO ; Soomin JANG ; Jeong-Hyun KIM ; Seockhoon CHUNG
Psychiatry Investigation 2023;20(11):1095-1102
Objective:
This study assessed the reliability and validity of the Stress and Anxiety to Viral Epidemics–9 items (SAVE-9) and Stress and Anxiety to Viral Epidemics–6 items (SAVE-6) scales for measuring viral anxiety among firefighters during the coronavirus disease-2019 pandemic.
Methods:
An online survey was conducted among 304 firefighters assigned in Gyeonggi-do. The SAVE-9 scale, initially developed for healthcare workers, was adapted for firefighters. We compared it with the SAVE-6 scale designed for the general population among the firefighters sample. The confirmatory factor analysis (CFA) was conducted to explore the factor structure of both scales. Internal consistency reliability was checked using Cronbach’s alpha and McDonald’s omega. Convergent validity was assessed in accordance with the Patient Health Questionnaire–9 and Generalized Anxiety Disorder–7 scales.
Results:
The SAVE-9 scale demonstrated a Cronbach alpha of 0.880, while the SAVE-6 scale yielded an alpha of 0.874. CFA indicated good model fits for both SAVE-9 and SAVE-6 scales among firefighters sample. The SAVE-9 and SAVE-6 comparably measures viral anxiety of firefighters.
Conclusion
Both of the SAVE-9 and SAVE-6 scales are reliable and valid instruments for assessing viral anxiety among firefighters during the pandemic.