Circadian rhythm is an oscillating biological rhythm that operates on a 24-hour cycle and is caused by an internal biological clock. Circadian rhythm regulates many physiological processes and behaviors in the human body, and it has been known that disturbance of circadian rhythm causes various diseases including cancer. The interaction between circadian rhythm and cancer appears in both directions, and chronotherapeutics, the concept of treatment according to circadian timing, has become particularly important in these days. In this article, we investigated the definition and physiological-behavioral outputs of circadian rhythm. The circadian rhythm disruption, circadian timing system and chronomodulated chemotherapy were reviewed in relation to cancer biology.

The treatment strategy for children with attention deficit/hyperactivity disorder (ADHD) mainly involves medication, although research on non-pharmaceutical treatments steadily continues. Neurofeedback is considered as a nonpharmacological treatment strategy for children with ADHD. In this review, the concept and principles of neurofeedback, the electroencephalography characteristics of children with ADHD, and the background for application of neurofeedback therapy in these subjects are described. The results of the latest studies are presented, showing that neurofeedback treatment seems to be effective in improving some symptoms, and that it can be useful as a complementary treatment. However, further research is needed to investigate whether neurofeedback alone may be as effective as drug treatments.

Background: Burnout is a syndrome resulting from chronic work-related stress, characterized by symptoms including “feelings of exhaustion, increased mental distance from one’s job, and reduced professional efficacy.” Human service providers are susceptible to burnout. Thus, this study aimed to investigate community mental health workers’ job stress, experiences with client violence, and burnouts and to analyze factors that affect burnout. Methods: This study used retrospective data from a survey of mental health workers at a mental health-related institution in a city. The data included sociodemographic characteristics, job stress, client violence, and quality of life. Results: From a total of 170 mental health workers, 67.6% were female. Subjects who were in lower age groups, had <1 year of work experience, were married, and were irregular workers were vulnerable to various job stressors. Factors associated with burnout were job demand, lack of reward, job insecurity, physical environment, other violence, and level of education. Conclusion We should create an environment wherein community mental health workers can be safe and satisfied with their work, which could lower workers’ job stress and prevent burnouts due to work. This, in turn, enhances the quality of care provided to people with mental health problems.

Objective: The purpose of this study was to evaluate the effects of adding music therapy (MT) to cognitive-behavioral therapy (CBT) on symptoms of smartphone/internet addiction and psychiatric comorbidities. Methods: Overall, 155 patients diagnosed with addiction were assigned to either the CBT-MT group or CBT group. Both groups received CBT for 8 weeks, while the CBT-MT group received additional MT. The intervention was completed by 67 and 71 participants in the CBT-MT and CBT groups, respectively. Results: The total scores of Young Internet Addiction Scale (YIAT) and Smartphone Addiction Proneness Scale (SAPS) decreased significantly (p<0.001 for both) in both groups, while the total scores of State Anxiety Inventory for Children (SAIC) (p<0.001), Trait Anxiety Inventory for Children (TAIC) (p<0.001), Conners-Wells’ Adolescent Self-Report Scale-Short form (CASS(S)) (p=0.048), and Barratt Impulsiveness Scale-11 (BIS-11) (p<0.001) decreased only in the CBT-MT group. The decrements in YIAT (p=0.025), SAIC (p=0.043), TAIC (p=0.011), and BIS-11 (p=0.012) in the CBT-MT group were significantly greater than those in the CBT group. Conclusion Combined MT and CBT improved the symptoms of smartphone/internet addiction, anxiety, and impulsivity in adolescents. This combination could therefore be an effective treatment of smartphone or internet addiction along with behavioral disorders such as anxiety and impulsivity.

Objectives: Hikikomori is a social condition characterized by social withdrawal. It is essential to develop an objective indicator to screen for this condition and provide early intervention. Therefore, this study verified the validity and reliability of a Korean version of the 25-item Hikikomori Questionnaire (HQ-25). Methods: Semi-structured interviews were conducted with participants at high risk of feeling loneliness and who were recruited through online and offline methods. Data based on clinical scales were collected, and after four weeks, a self-report questionnaire was administered to a few participants to confirm the degree of agreement. Results: One hundred forty-three people were enrolled, out of which 45 were identified as hikikomori. There was a significant difference in scores between the hikikomori group and the unaffected group (64.44 and 39.30, respectively; p<0.01). Convergent diversity and test-retest reliability were satisfactory. The area under the receiver operating characteristic curve was 0.817. Based on confirmatory factor analysis, the existing model was found suitable. In this study, sensitivity and specificity were 88.9% and 52.0% at 40.5 points, and 84.4% and 49.0% at 41.5 points, respectively. Conclusion The Korean version of the HQ-25 has secure validity and reliability. This scale can be beneficial in the screening and early intervention of hikikomori.

Objective: Following the coronavirus disease-2019 (COVID-19) outbreak, the importance of addressing acute stress induced by psychological burdens of diseases became apparent. This study attempted to evaluate the effectiveness of a new mode of psychiatric intervention designed to target similar psychological crises. Methods: Participants included 32 out of 114 COVID inpatients at a hospital in Daegu, Korea, who were assessed between March 30 and April 7, 2020. Multiple scales for screening psychological difficulties such as depressed mood, anxiety, insomnia, acute stress, and suicidality were done. Psychological problem evaluations and interventions were conducted in the form of consultations to alleviate participants’ psychological challenges via telepsychiatry. The interventions’ effects, as well as clinical improvements before and after the intervention, were analyzed. Results: As a result of screening, 21 patients were experiencing psychological difficulties beyond clinical thresholds after COVID-19 infection (screening positive group). The remaining 11 were screening negative groups. The two groups differed significantly in past psychiatric histories (p=0.034), with the former having a higher number of diagnoses. The effect of the intervention was analyzed, and clinical improvement before and after the intervention was observed. Our intervention was found to be effective in reducing the overall emotional difficulties. Conclusion This study highlighted the usefulness of new interventions required in the context of healthcare following the COVID-19 pandemic.

Objectives: ：This study assessed the psychological impact of quarantine during the coronavirus disease 2019 (COVID-19) outbreak. Methods: ：A total of 2080 participants filled the self-report questionnaire from March 17 to April 20, 2020 in Daegu, Republic of Korea. An online link was sent to currently or previously quarantined participants. The self-report questionnaire included patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7), primary care post-traumatic stress disorder screen for diagnostic and statistical manual-5 (PTSD-PC), state-trait anger expression inventory (STAXI), and P4 suicidality screener scale (P4). PHQ-9 score of 5 or more and 9 or less indicates mild to moderate depressive symptoms, and 10 or more indicates severe depressive symptoms; A GAD-7 score of 5 or more and 14 or less indicates mild to moderate anxiety symptoms, and a score of 15 or more indicates severe anxiety symptoms; A PTSD-PC-5 score of 2 indicates mild to moderate PTSD; a score of 3 or higher indicates severe PTSD; A STAXI score of 14 or higher indicates severe anger symptoms; In P4, the cut-off points for each self-report questionnaire were set as mild suicidal thoughts at 1 point or more and 2 points or less, and severe suicide thoughts at 3 or more points. Logistic regression analyses were used to explore COVID-19-related risk factors. Results: ：The prevalence of mental health symptoms among the survey respondents was at 52.5% for depression, 44.5% for anxiety, 39.4% for post-traumatic stress, 31.6% for anger, and 10.9% for suicidal ideation. Participants with confirmed or suspected COVID-19 family members showed a high risk for symptoms of anxiety, posttraumatic stress, and anger. Participants with financial loss had increased symptoms of depression, anxiety, posttraumatic stress, anger, and suicidal ideation. Participants with a history of medical/psychiatric illnesses reported more symptoms of depression, anxiety, post-traumatic stress, anger, and suicidal ideation. Having inadequate basic supplies during quarantine was associated with negative mental health outcomes. Conclusions ：Quarantine had a negative psychological impact on all five mental health factors. The risk of depression, anxiety, post-traumatic stress disorder, anger, and suicidality increased among those who suffered from financial losses due to COVID-19. The associated risk factors will help identify populations at risk for mental health problems and implement mental health intervention policies.

Background: Lung cancer is associated with significant psychological distress, including fear of progression (FoP). Because insomnia and depression are highly prevalent and associated with FoP, we examined the association between FoP, insomnia, and depression in cancer patients. Furthermore, we tested the mediation effect of cancer-related dysfunctional beliefs about sleep (C-DBS) on this association. Methods: We analyzed data collected from patients with surgically resected non-small cell lung cancer from a single-center randomized controlled study investigating digital healthcare applications. Baseline demographic and clinical variables were collected. In addition, selfreported questionnaires including the Fear of Progression Questionnaire-Short Form, Patients Health Questionnaire-9 items (PHQ-9), Insomnia Severity Index, and C-DBS were administered. Results: Among the 320 enrolled patients with lung cancer, a regression model showed that FoP was predicted by age (β = −0.13, P = 0.007), PHQ-9 (β = 0.35, P < 0.001), and C-DBS (β = 0.28, P < 0.001). Insomnia did not directly influence FoP, but C-DBS mediated the association. Depression directly influenced FoP, but C-DBS did not mediate this association. Conclusion Among patients with surgically resected lung cancer, C-DBS mediated the effects of severity of insomnia on FoP. Depression directly influenced FoP, but C-DBS did not influence this association. To reduce FoP among patients with lung cancer, C-DBS should be addressed in the cognitive behavioral therapy module.

BACKGROUND AND OBJECTIVES: Proficient differentiation of human pluripotent stem cells (hPSCs) into specific lineages is required for applications in regenerative medicine. A growing amount of evidences had implicated hormones and hormone-like molecules as critical regulators of proliferation and lineage specification during in vivo development. Therefore, a deeper understanding of the hormones and hormone-like molecules involved in cell fate decisions is critical for efficient and controlled differentiation of hPSCs into specific lineages. Thus, we functionally and quantitatively compared the effects of diverse hormones (estradiol 17-β (E2), progesterone (P4), and dexamethasone (DM)) and a hormone-like molecule (retinoic acid (RA)) on the regulation of hematopoietic and neural lineage specification. METHODS AND RESULTS: We used 10 nM E2, 3 μM P4, 10 nM DM, and 10 nM RA based on their functional in vivo developmental potential. The sex hormone E2 enhanced functional activity of hematopoietic progenitors compared to P4 and DM, whereas RA impaired hematopoietic differentiation. In addition, E2 increased CD34⁺CD45⁺ cells with progenitor functions, even in the CD43⁻ population, a well-known hemogenic marker. RA exhibited lineage-biased potential, preferentially committing hPSCs toward the neural lineage while restricting the hematopoietic fate decision. CONCLUSIONS: Our findings reveal unique cell fate potentials of E2 and RA treatment and provide valuable differentiation information that is essential for hPSC applications.
Dexamethasone ; Humans ; Induced Pluripotent Stem Cells ; Pluripotent Stem Cells ; Progesterone ; Regenerative Medicine ; Tretinoin