OBJECTIVES: The aim of this study was to investigate how mental health professionals in Korea evaluate the burden of disease caused by psychiatric disorders and to propose future directions of the public mental health policies. METHODS: A questionnaire was mailed to 240 mental health professionals, who were composed of psychiatrists from mental hospitals and staffs who are nurses, clinical psychologists and social workers working in the community mental health centers in June, 2004. Two hundred twenty four out of two hundred forty subjects (93.3%), which were composed of 104 psychiatrists and 120 staffs, completed the questionnaire. The questionnaire included 6-item questions about the burden of disease in Korea. RESULTS: Mental health professionals reported that the five diseases with the biggest burden were malignant neoplasms, traffic accidents, schizophrenia, alcohol use disorders and cerebrovascular diseases, consecutively. The burden of alcohol use disorders, cerebrovascular diseases, traffic accidents, unipolar depressive disorder and malignant neoplasms are expected to increase over the next several years. The proportions of psychiatric disorders among all the diseases in terms of burden of disease and medical costs were estimated as 18.4% (+/-12.8) and 12.0% (+/-11.7) respectively. CONCLUSION: This study showed that many of Korean mental health professionals have under-estimated burden of psychiatric disorders, especially, unipolar depressive disorder. It would be necessary to emphasize the importance of unipolar depressive disorder in applying educational and public programs for the mental health professionals, as well as for the general population.
Accidents, Traffic ; Community Mental Health Centers ; Depressive Disorder ; Hospitals, Psychiatric ; Korea ; Mental Health ; Postal Service ; Psychiatry ; Surveys and Questionnaires ; Schizophrenia ; Social Workers

OBJECTIVES: There is a increasing need to recruit and retain more psychiatrists who can plan and implement organized programs to work with chronic mentally ill patients in community settings. The aim of study is to discover what training is currently in place to prepare psychiatrist for work in "community" or "public" settings. METHODS: Survey questionnaires were mailed to 85 residency training directors and 10 leaders of community mental health in 2005. Response rate was 75%. RESULTS: Academic seminar about community mental health were not administered to residents in 63% of training hospitals. Forty one out of 64 training hospitals had community mental health rotation programs. Community mental health center (50%) and day hospital (36%) were the most common type of programs. Few general hospital had affiliation with community mental health programs. The amount of time for clinical rotation varied from less than three months part time to 6 months fulltime, with most frequent form of one day per week for three month in second or third year of psychiatry residents. CONCLUSION: Further steps are needed to improve residency training curricula and to encourage well qualified psychiatrist to choose careers in community psychiatry.
Community Psychiatry ; Curriculum ; Hospitals, General ; Humans ; Hypogonadism ; Internship and Residency ; Mental Health ; Mentally Ill Persons ; Mitochondrial Diseases ; Ophthalmoplegia ; Postal Service ; Psychiatry ; Surveys and Questionnaires

OBJECTIVES: This study was conducted to explore the relationship between non-psychotic, common mental disorders and work loss days, using data from 2001 KECA survey. METHODS: Six thousands and two hundred seventy-five community dwelling subjects, aged 18 years or older, were interviewed by using the Korean version of Composite International Diagnostic Interview (K-CIDI). Common mental disorders during last 12 months were assessed by work loss days of past month with questions from the WHO Disablement Assessment Scale version 2 (WHODAS-II). Main analysis was done by Linear and Logistic regressions to identify the association between mental disorders and work loss days. RESULTS: As expected, mental disorders were associated with substantial work loss days. Subjects with major depression had highest work loss days. Many common anxiety disorders like social phobia, specific phobia and posttraumatic stress disorder were also associated with high work loss days. CONCLUSION: Our results show that a number of common mental disorders might have substantial effect on job function, quality of life and, subsequently, social productivity. Therefore it seems that more attention for public mental health efforts is warranted.
Aged ; Anxiety Disorders ; Depression ; Efficiency ; Humans ; Logistic Models ; Mental Disorders ; Mental Health ; Phobic Disorders ; Quality of Life ; Stress Disorders, Post-Traumatic

OBJECTIVES: Neurobiological and pharmacological research has suggested that the dysregulation of the central noradrenergic systems might be involved in the pathophysiology of ADHD. The aim of this study was to examine the association of the alpha- 1C-adrenergic receptor gene (ADRA1C) with ADHD in Korean subjects. METHODS: In a case-control study, we assessed 186 DSM-IV ADHD probands and 150 normal controls. One hundred and eight trios were studied in a family-based association analysis. Psychiatric diagnoses were derived through structured diagnostic interviews. For the clinical evaluation of the ADHD subjects, the Child Behavior Checklist (CBCL), the ADHD Rating Scale-IV (ARS) and the Junior Temperament and Character Inventory (JTCI) were administered. A computerized continuous performance test (CPT) was used to measure the inattention and impulsivity of the ADHD children. RESULTS: There were no significant differences in the genotype or allele frequencies of the ADRA1C PstI polymorphism between the ADHD and control group (p<0.05). The transmission disequilibrium test (TDT) analysis observed no evidence for biased transmission of any of the alleles of the PstI polymorphism. There were no significant differences in the CPT or JTCI profiles between those ADHD subjects with the CC genotype and those with the other (CT+TT) genotypes at the PstI polymorphism. CONCLUSION: The results of this study do not support the ADRA1C as a major genetic susceptibility factor in ADHD.
Alleles ; Attention Deficit Disorder with Hyperactivity ; Bias (Epidemiology) ; Case-Control Studies ; Checklist ; Child ; Child Behavior ; Diagnostic and Statistical Manual of Mental Disorders ; Endophenotypes ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Temperament

OBJECTIVES: This study was conducted to investigate the reliability and validity of the short form, parental version of the Korean SNAP-IV. METHODS: The Korean SNAP-IV, SNAP, CPRS were applied to the groups of 605 control and 94 ADHD children, aged 6-12 years. Test-retest reliability, internal consistency and split half reliability were performed as a reliability test and criterion validity, factor analysis and discriminant validity were also performed as a validity test. RESULTS: The Coefficient of test-retest reliability and split half reliability were 0.84/0.86 and 0.73/0.78 for both inattention and hyperactivity/impulsivity subscales. The Internal consistency was also excellent. The Criterion validity and discriminant validity rates were between 0.59 and 0.82. Three factors were identified in factor analysis. CONCLUSION: This study demonstrates that the short form, parental version of the Korean SNAP-IV is a reliable and valid instrument in the evaluation and screening of ADHD-related behaviors in children.
Aged ; Cardiopulmonary Resuscitation ; Child ; Humans ; Mass Screening ; Parents ; Reproducibility of Results

OBJECTIVES: We aimed to identify the degree of perceived need and use of child mental health services, and to examine the factors associated with the perceived need and use of the child mental health services. METHODS: The sample consisted of 3,477 children aged 8 to 13 years. The parents completed the sociodemographic data, the Korean version of the Child Behavior Checklist (K-CBCL), and the Korean version of DuPaul's Attention Deficit Hyperactivity Disorder Rating Scale (K-ARS). RESULTS: Overall, 10% of children demonstrated the need for mental health services, and 2.36% utilized the child mental health services. All subcategory scores of K-CBCL and K-ARS were significantly low in the no help needed group. Factors associated with the actual use of child mental health services included social problems and thought problems. CONCLUSION: The demand for child mental health services is high, but only a small number of children are using mental health services. To increase actual use, it is necessary to educate and campaign for various child mental health.
Aged ; Attention Deficit Disorder with Hyperactivity ; Checklist ; Child ; Child Behavior ; Humans ; Mental Health ; Mental Health Services ; Parents ; Social Problems

OBJECTIVES: The individual's ability to recognize and describe emotion in self and others is an important concept of many psychiatric disorders. The purpose of this study was to investigate emotional awareness deficits in patients with alcohol dependence. METHODS: 55 male inpatients with alcohol dependence and 28 male normal controls were evaluated by the Korean version of the Levels of Emotional Awareness Scale (LEAS-K), the Korean version of the 20-item Toronto Alexithymia Scale (TAS-20K), the Openness Experience Inventory (OEI) and the Beck Depression Inventory (BDI). The LEAS-K is an objective measure to assess the ability to be aware of one's own or another's emotions and the TAS-20 is the most widely used subjective measure of alexithymia. Scores of these scales were compared between two groups using ANCOVA controlling age and BDI scores. RESULTS: The LEAS-K scores were significantly lower in alcohol-dependent patients than normal controls. The TAS-20K total scores, factor 1 (Difficulty to Identifying Feeling, DIF) and factor 3 (Externally Oriented Thinking, EOT) were significantly higher in alcohol-dependent patients than normal controls. In contrast to the LEAS-K, the TAS-20K scores correlated significantly with the BDI scores. CONCLUSION: Emotional awareness is impaired in alcohol-dependent patients and it may not be related with depressive mood. Additional studies are needed to explore the significance of alexithymia, especially impaired emotional awareness, and its relationship to depressive mood in patients with alcohol dependence.
Affective Symptoms ; Alcoholism ; Depression ; Humans ; Inpatients ; Male ; Thinking ; Weights and Measures

OBJECTIVES: This study aimed to investigate the prospective associations of premenstrual dysphoric disorder (PMDD) with quality of life, socio-occupational function and disability. METHODS: 170 nurses were recruited from two general hospitals. Interviews were made at baseline and at four follow-up points (two mid follicular phases and two late luteal phases of the two consecutive menstrual cycles). The baseline evaluation consisted of sociodemographic characteristics and menstrual history. PMDD was diagnosed by DSM-IV criteria after observation of the two menstrual cycles. The follow-up evaluations were consisted of the World Health Organization Quality of Life-Brief form, the Social and Occupational Functioning Assessment Scale, and the World Health Organization Disability Assessment Scale-II. RESULTS: PMDD was detected 15 (8.8%) of 170 participants. The PMDD group showed significantly worse quality of life and socio-occupational functioning than the none-PMDD group particularly at the late luteal phases. No significant differences were found in sociodemographic characteristics and menstrual history between those with and without PMDD. CONCLUSION: PMDD was prospectively associated with worse quality of life and socio-occupational functioning in this study group.
Diagnostic and Statistical Manual of Mental Disorders ; Female ; Follow-Up Studies ; Hospitals, General ; Menstrual Cycle ; Prospective Studies ; Quality of Life ; World Health Organization

OBJECTIVES: The EPDS (Edinburgh Postnatal Depression Scale) is a 10-items self-report scale designed as a specific instrument to detect postnatal depression by Cox et al. (1987). This study was to determine the optimal cut-off point of the KEPDS for postpartum depression in Korea. METHODS: The 239 pregnant women assessed their own psychiatric features with the Korean version of the Edinburgh Postnatal Depression Scale (K-EPDS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Rosenberg Self-Esteem Scale (RSES) and Marital Satisfaction Scale (MSS) at 6 months of pregnancy, 1 week after delivery, and 6 weeks after delivery. Subjects above 9 points of K-EPDS at 6 week after delivery were interviewed with Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to confirm postpartum depression. RESULTS: The prevalence of postpartum depression was 12.6% (30/239 pregnant women) in our study. The total scores of K-EPDS at 6 weeks after delivery were higher significantly than those of normal group. The score gap of K-EPDS between the depressed pregnant group and the normal pregnant group was increased after the delivery. However, there were no differences in the epidemiological characteristics and the BDI scores at 6 weeks after delivery between groups. Using the AUC (area under the curve), the optimal point to assess the postpartum depression was revealed as 6 weeks after delivery (AUC=85.8%) or 24 weeks of pregnancy (83.7%). The cut-off point of K-EPDS to detect postpartum depression among pregnant women was 9/10 score of K-EPDS (AUC= 81.8%). CONCLUSION: In the K-EPDS, cut-off score of 9/10 was optimal to assess the postpartum depression, and K-EPDS at 6 weeks of delivery was more useful than any other point of time. K-EPDS administrated during pregnancy may be a useful tool to find the vulnerability on the postpartum depression.
Anxiety ; Area Under Curve ; Axis, Cervical Vertebra ; Depression ; Depression, Postpartum ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Glycolates ; Humans ; Postpartum Period ; Pregnancy ; Pregnant Women ; Prevalence

OBJECTIVES: Both story and cartoon task are sensitive to evaluate social cognition deficit in schizophrenia. However it is unclear whether social cognition deficits indexed by these tasks of schizophrenia reflect social functioning in their real life. To this purpose, we investigated the effect of social cognitive deficits detected in schizophrenic patients on social functioning. METHODS: Our investigation involved twenty-two schizophrenic patients and normal subjects. The story and cartoon tasks as mental state reasoning tasks and the 'Social Functioning Scale (SFS)' as a social functioning measure were administered for all subjects. RESULTS: The schizophrenic patients with average level of intelligence and mild psychotic symptoms, regarded as almost remitted, showed significantly poor performance on all of story task, cartoon task, and SFS. However, after controlling IQ's effects, only the performances on the story task were significantly contributed to the performances on the SFS, especially on subscales of 'Withdrawal', 'Independence performance' and 'Independence competence'. CONCLUSION: These findings indicate that performance of the story task is considered as a good predictor of social functioning for the schizophrenic patients in remission.
Cognition ; Humans ; Intelligence ; Schizophrenia