OBJECTIVE: The Center for Epidemiological Studies Depression Scale (CES-D) is designed to measure the current level of depressive symptomatology in the general population. However, no review has examined whether the scale is reliable and valid among children and adolescents in Korea. The purpose of this study was to test whether the Korean form of the CES-D is valid in adolescents. METHODS: Data were obtained from 1,884 adolescents attending grades 1–3 in Korean middle schools. Reliability was evaluated by internal consistency (Cronbach’s alpha). Concurrent validity was evaluated by a correlation analysis between the CES-D and other scales. Construct validity was evaluated by exploratory factor and confirmatory factor analyses. RESULTS: The internal consistency coefficient for the entire group was 0.88. The CES-D was positively correlated with scales that measure negative psychological constructs, such as the State Anxiety Inventory for Children, the Korean Social Anxiety Scale for Children and Adolescents, and the Reynold Suicidal Ideation Questionnaire, but it was negatively correlated with scales that measure positive psychological constructs, such as the Korean version of the Rosenberg Self-Esteem Scale and the Connor-Davidson Resilience Scale-2. The CES-D was examined by three-dimensional exploratory factor analysis, and the three-factor structure of the scale explained 53.165% of the total variance. The variance explained by factor I was 24.836%, that explained by factor II was 15.988%, and that explained by factor III was 12.341%. The construct validity of the CES-D was tested by confirmatory factor analysis, and we applied the entire group’s data using a three-factor hierarchical model. The fit index showed a level similar to those of other countries’ adolescent samples. CONCLUSION: The CES-D has high internal consistency and addresses psychological constructs similar to those addressed by other scales. The CES-D showed a three-factor structure in an exploratory factor analysis. The present findings suggest that the CES-D is a useful and reliable tool for measuring depression in Korean adolescents.
Adolescent Psychiatry ; Adolescent ; Anxiety ; Child ; Depression ; Epidemiologic Studies ; Fibrinogen ; Humans ; Korea ; Prothrombin ; Psychometrics ; Suicidal Ideation ; Thromboplastin ; Weights and Measures

Social capital, defined as an individual’s social relationships and participation in community networks, encompasses resources, such as the exchange of favors, maintenance of group norms, stocks of trust, and exercise of sanctions available to members of social groups. Social capital may lower the risk of mental disorders while increasing the resilience capacity, adaptation, and recovery. Interventions targeting social capital may offer a cost-effective approach to preventing and ameliorating these conditions. This study evaluated the concept and importance of social capital because mental well-being is influenced by individual characteristics, the socioeconomic situation, and broader environmental factors to which individuals are exposed. Recognizing the growing significance of social capital in this context, the study examined its role, its relationship with depression, and the potential importance of social capital in South Korea. Although the definition of social capital is broad, the emphasis is placed on the role of linking social capital. Moving beyond an individual-centric perspective on identifying the factors contributing to depression, this paper suggests that social capital can serve as a crucial starting point for changing the environment to which individuals belong, i.e., structural and intermediary determinants. In the macrolevel perspective of mental health intervention, this paper proposes the need to attribute significance and awareness to numerous studies already implemented in various local communities through social capital.

Phendimetrazine and related amphetamine-like compounds are used widely as appetite suppressants in Korea. We report on a patient who developed psychotic disorder and dependence while using phendimetrazine. A 25-year-old female with no psychiatric history began experiencing hallucination of bugs after using phendimetrazine for weight loss for five months. She was admitted and the drug was stopped. Three days later, her psychotic symptoms had subsided and she returned home. Two months after discharge, against medical advice, she returned to a clinic to obtain phendimetrazine for its anorectic effect. She continued using phendimetrazine because she had developed withdrawal symptoms and experienced cravings for it. Within two months of restarting the drug, she had developed paranoid delusions, auditory and olfactory hallucinations. She was readmitted, and was confirmed to have a dependence on phendimetrazine. This case provides a warning that amphetamine-related anorectics can cause psychotic disorder and dependence.
Adult ; Appetite Depressants ; Delusions ; Female ; Hallucinations ; Humans ; Korea ; Morpholines ; Psychotic Disorders ; Substance Withdrawal Syndrome ; Weight Loss

Tardive blepharospam is characterized by repetitive, forceful, and sustained involuntary contractions of the orbicularis oculi. We report here one case of neuroleptic-induced tardive blepharospasm that developed during high-dose amisulpride treatment and was treated with clozapine. The patient was a 29-year-old man with a 6-year history of schizophrenia. After 33 months of amisulpride treatment (1200 mg/day), involuntary eye-blinking had developed. Following exclusion of all other possible etiopathological causes of the blepharospasm, we decided to switch the drug treatment from amisulpride to clozapine. On the fourteenth day of clozapine (250 mg/day) treatment, we observed significant improvements in eye-blinking and psychotic symptoms. Four months later, the eye-blinking had remitted completely. We suggest that amisulpride may cause blepharospasm and lead to an impaired ability to perform daily activities. Therefore, we recommend that clinicians regularly monitor involuntary movements in patients receiving antipsychotic treatment, especially when high doses of amisulpride are involved.
Adult ; Blepharospasm ; Clozapine ; Contracts ; Dyskinesias ; Humans ; Organothiophosphorus Compounds ; Schizophrenia ; Sulpiride

Kleine-Levin syndrome is a rare disorder which usually affects adolescent males and is characterized by periodic hypersomnia, hyperphagia and abnormal behavior. This is an unexplained clinical syndrome for which several etiologies have been entertained with no standard treatment is yet available. A 18-year old woman began suffering from recurrent hypersomnia, hyperphagia, and behavioral disturbances such as irritability, derealization, and amnesia. She was normal between the episodes and diagnosed as Kleine-Levin syndrome. In the course of about two years she had 11 episodes and the mean interval between the episodes was 52.8+/-16.7 days. After application of amantadine, there were two mild episodes and then she had no episodes for more than 6 months. This case suggests the possible role of amantadine in the treatment of Kleine-Levin syndrome.
Adolescent ; Amantadine* ; Amnesia ; Depersonalization ; Disorders of Excessive Somnolence ; Female* ; Humans ; Hyperphagia ; Kleine-Levin Syndrome* ; Male

OBJECTIVE: As homeless people increased in urban areas after the economic crisis in Korea, they became a serious social problem. Foreign research showed that many homeless people had chronic mental illnesses which were closely related with the cause and prognosis of homelessness. But very little was known about the prevalence of mental disorders in Korean homeless people. This study tried to capture the overall picture of mental disorders in homeless people. METHOD: The study subjects were 216 homeless people who stayed at two Pusan shelters between late 1998 and early 1999. Questionnaires on sociodemographic data were administered to the subjects, and then diagnoses of major DSM-IV Axis I mental disorders were made using Structured Clinical Interview for DSM-IV Axis I Disorders(SCID). The lifetime and current prevalence of mental disorders in this study were compared to those from other studies in Korean general population and in foreign homeless people. RESULTS: The lifetime prevalence of major DSM-IV mental disorders(mood disorders, psychotic disorders, and substance use disorders) of 216 homeless people was 60.1%, and current prevalence was 35.7%. The lifetime prevalence of major depressive disorders was 22.5% which was higher than that of foreign studies. The lifetime prevalence of alcohol use disorder was 47.4%. The lifetime prevalence of psychotic disorders was 3.8%, and among them the lifetime prevalence of schizophrenia was 1.9% which was lower than that of foreign studies. CONCLUSIONS: In Korean homeless people, mood disorders and substance use disorders were the main mental disorders and psychotic disorders such as schizophrenia were less than in foreign homeless people. The plans to approach and treat homeless people with mental disorders should be made.
Axis, Cervical Vertebra ; Busan ; Depressive Disorder, Major ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiologic Studies* ; Homeless Persons ; Humans ; Korea ; Mental Disorders* ; Mood Disorders ; Prevalence ; Prognosis ; Psychotic Disorders ; Surveys and Questionnaires ; Schizophrenia ; Social Problems ; Substance-Related Disorders

OBJECTIVES: The purpose of this study was to examine the effects of positive psychological characteristics on posttraumatic stress symptoms after traumatic experiences. METHODS: The subjects were 97 firefighters (83 males and 14 females), who completed the Life Events Scale, the Rosenberg Self-Esteem Scale, the Connor-Davidson Resilience Scale, and the Impact of Event Scale-Revised Korean version. Pearson product-moment correlation coefficients were computed to examine the relationships among the variables, and Structural Equation Modeling was used to investigate the mediation process in the relationships among traumatic experiences, positive psychological characteristics, and posttraumatic stress. RESULTS: The results showed that self-esteem had a mediating effect on the relationship between traumatic experiences and posttraumatic stress symptoms. Traumatic experiences affected posttraumatic stress symptoms not only directly, but also through self-esteem to posttraumatic stress symptoms. Therefore the lower firefighters' self-esteem was, the more posttraumatic stress symptoms occurred. Resilience, however, apparently had no function as mediating variable in the relationship between traumatic experiences and posttraumatic stress symptoms. Traumatic experiences and resilience each seemed to affect posttraumatic stress symptoms directly. Hence, the lower firefighters' resilience was, the more posttraumatic stress symptoms occurred. CONCLUSION: This study showed that self-esteem had a mediating effect on the relationship between traumatic experiences and posttraumatic stress symptoms. We also found that resilience affects posttraumatic stress symptoms directly, regardless of the number of traumatic experiences. Likewise, these results showed that we should be concerned in positive psychological characteristics such as self-esteem and resilience in order to prevent posttraumatic stress symptoms.
Firefighters ; Humans ; Male ; Negotiating

PURPOSE: To analyze the overall clinical outcome, overall assessment, and patient's satisfaction rate of subtalar arthrodesis using the cannulated compression screw. MATERIALS AND METHODS: This study is based on 17 patients, 17 feet who underwent subtalar arthrodesis using the cannulated compression screw from March, 1997 to March, 2004 with at least 1 year follow-up. The average follow-up period was 33.0 months (12 to 72 months). Functional results were assessed using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS) score, and Visual Analysis Scale (VAS) pain score, patients' returning to previous occupation and patients' satisfaction rate were also evaluated. RESULTS: The mean AOFAS scores at final follow-up were 80.4 points (range 66~92). The satisfactory rates were as follow. Thirteen patients (76.4%) were at least satisfied with surgical result at final follow-up. Patients' VAS pain score was average 2.8 points (1~6). Fourteen (82.3%) patients returned to previous job at mean postoperative period of 11.3 months (range 3-18 months). Patients' work efficiency after returning to previous occupation was 68.7% (range 33~100%). There were 9 complications which were 3 cases of sural nerve injury, 1 case of valgus malunion, and 5 cases of the hindfoot residual pain. CONCLUSION: We obtained the satisfactory functional results with relatively high patient satisfaction rate of 76%. So we conclude that subtalar arthrodesis using the cannulated compression screw is a reliable method for addressing the painful end-stage subtalar osteoarthritis and unreconstructible comminuted calcaneal fractures. However we also found out that average 11 months were necessary for patients to return to their job.
Ankle ; Arthrodesis* ; Follow-Up Studies ; Foot ; Humans ; Occupations ; Osteoarthritis ; Patient Satisfaction ; Postoperative Period ; Sural Nerve

PURPOSE: To analyze the overall clinical outcome, overall assessment, and patient's satisfaction rate of subtalar arthrodesis using the cannulated compression screw. MATERIALS AND METHODS: This study is based on 17 patients, 17 feet who underwent subtalar arthrodesis using the cannulated compression screw from March, 1997 to March, 2004 with at least 1 year follow-up. The average follow-up period was 33.0 months (12 to 72 months). Functional results were assessed using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS) score, and Visual Analysis Scale (VAS) pain score, patients' returning to previous occupation and patients' satisfaction rate were also evaluated. RESULTS: The mean AOFAS scores at final follow-up were 80.4 points (range 66~92). The satisfactory rates were as follow. Thirteen patients (76.4%) were at least satisfied with surgical result at final follow-up. Patients' VAS pain score was average 2.8 points (1~6). Fourteen (82.3%) patients returned to previous job at mean postoperative period of 11.3 months (range 3-18 months). Patients' work efficiency after returning to previous occupation was 68.7% (range 33~100%). There were 9 complications which were 3 cases of sural nerve injury, 1 case of valgus malunion, and 5 cases of the hindfoot residual pain. CONCLUSION: We obtained the satisfactory functional results with relatively high patient satisfaction rate of 76%. So we conclude that subtalar arthrodesis using the cannulated compression screw is a reliable method for addressing the painful end-stage subtalar osteoarthritis and unreconstructible comminuted calcaneal fractures. However we also found out that average 11 months were necessary for patients to return to their job.
Ankle ; Arthrodesis* ; Follow-Up Studies ; Foot ; Humans ; Occupations ; Osteoarthritis ; Patient Satisfaction ; Postoperative Period ; Sural Nerve

A 73-year-old man was scheduled for the surgical reduction of fractured femur which occurred ar 3 months ago by the accident. The mental status of the patient was stuporous (Glasgow coma scale: 5) due to the complication of the head trauma. We performed nerve blocks (femoral, sciatic, lateral femoral cutaneous, and illiohypogastric nerve blocks) for the surgical reduction of left femur with 55 ml of 0.25% ropivacaine. The electroencephalography was monitored continuously during the 4 hour operation as well as monitoring the hemodynamic and respiratory parameters. The operation was performed successfully and the patient recovered uneventfully.
Aged ; Coma ; Craniocerebral Trauma ; Electroencephalography ; Femur ; Hemodynamics ; Humans ; Lower Extremity* ; Nerve Block* ; Stupor