We report a case of subacute psychotic symptoms in a patient with germ cell tumor (GCT). The 32-year-old male patient showed progressive psychotic symptoms with diagnosis of GCT. His psychotic symptoms included delusions of reference and persecution. Brain magnetic resonance imaging, electroencephalography, and laboratory examinations were performed to evaluate any other causes. The clinical, neuroimaging, and laboratory review in this case suggested that the progressively developed psychotic symptoms that led to chronic deterioration were caused by the GCT. This is the case report in which subacute atypical psychotic symptoms in his thirties could develop from a GCT based on previous basic research findings showing the correlations of psychotic symptoms with GCT although it has the limitation of so early speculation.

Objectives: This study was conducted to investigate the relationship between personality and decision making in the group of young male depression patients. Methods: Eighty-four male depression patients were subjected to the following test: Beck’s Depression Inventory-II (BDI-II), and Beck’s Anxiety Inventory (BAI), Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV), Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Personality Assessment Inventory (PAI), Temperament Character Inventory-Revised Short version (TCI-RS), Delay Discounting Task (DDT), Game of Dice Task (GDT). Pearson’s correlation analysis was used to determine the association between DDT and GDT performance results and self-report examination. Multiple linear regression models were conducted to figure out the causal relationship between risky choice of GDT and the variables suspected of having a linear relationship. The collected data was analyzed using SPSS 21. Results: PAI mania, borderline features, dominance and novelty seeking of TCI-RS were positively correlated with the number of risky choices of GDT. Full Scale Intelligence Quotient, BDI-II, BAI score had no significant correlation with DDT and GDT. There was also no correlation between DDT and GDT. Conclusions The results suggest that risk taking decision is related to personality traits such as novelty seeking, while inter-temporal choice is not related to personality aspects. It could be inferred that two different decision-making processes take place independently at different brain regions.

Objectives: Schizophrenia (SPR) is the most devastating mental illness that causes severe deterioration in social and occupational functioning, but, the aetiology remains unknown. The aim was to identify patterns of association and segregation for genetic variants and to identify the genes and signalling pathways that determine the risk of developing SPR, through a family-based Genome-wide association study. Methods: We have recruited 27 probands(with SPR) with their parents and siblings whenever possible. DNA was extracted from blood sampling of 58 individuals in 27 families and analysed in an Illumina core exome single nucleotide polymorphism (SNP) array. A family-based association test was used to derive SNP association values across all chromosomes. Results: Although none of the final 800,000 SNPs reached the genome-wide significant threshold of 5×10-8 , the most significant 3 SNPs were within the 10-5 -10-7 . Conclusions This confirms that SPR is not monogenic but results as a consequence of interactions between multiple host genes and possibly also environmental factors. The present approach provides novel insights into the mechanisms underlying SPR and raises the possibility of identifying individuals at risk of acquiring this condition. In this study, several possible susceptibility genes have been identified that are linked to a range of different pathways, which could reflect the mind-body interaction that is included in the psychiatric genomics consortium.

Objectives: ：Neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio (PLR) are indicators of inflammation. Several studies have evaluated their relationship with bipolar disorder severity, but the results are controversial. Here, we investigate the relationship between inflammatory ratios and the severity and clinical characteristics of bipolar disorder. Methods: ：We retrospectively reviewed the medical records of bipolar disorder patients who met the inclusion criteria and admitted to Kosin University Gospel Hospital between January 2010 and August 2021. NLR, MLR and PLR were measured according to the complete blood count. Severity was assessed by the Young Mania Rating Scale (YMRS) in hypo/manic episode patients, the Hamilton Rating Scale for Depression (HAMD) in depressive episode patients. Patients are grouped by presence of two clinical features, current psychotic features and history of suicide attempts. Results: ：181 subjects, of whom 123 were women and 58 men, were included. Subjects with higher NLR had higher HAMD scores (N=36, r=0.337, p=0.045). We found no significant correlation between YMRS and the inflammatory biomarkers. Patients with previous suicide attempts exhibited a greater PLR than those without previous suicide attempts (N[SA+]=52, N[SA-]=129, p=0.035). There was no significant difference in inflammatory ratios with respect to psychotic features. Conclusions ：We found a possible correlation between the severity of bipolar depression and inflammatory indicators in the Korean population, in addition to correlation between previous suicidal attempt of bipolar disorder and inflammatory indicators. A well-designed prospective study involving a larger cohort is needed in the future.

Objectives: ：Depression is known to be very common for coexistence with physical diseases, but reports of this are not well known in Korea. The purpose of this study is to investigate demographic factors related to adult depression in Korea and the association between physical diseases and depression. Methods: ：This study used raw data from the 7th National Health and Nutrition Survey of the Korea Centers for Disease Control and Prevention in 2016 and 2018, and analyzed by integrating data from adults over the age of 19. Patient Health Questionnaire-9 was applied to the diagnosis of depression. Cross-analysis and logistic regression analysis were used for the association with depression according to socio-demographic characteristics and health-related characteristics. Results: ：The point-prevalence of depression in Korea using Patient Health Questionnaire-9 is 5.4%. Regarding sociodemographic characteristics, risks of depression were increased among the elderly, women, people with low household income, and people with low education levels. It was analyzed that the risk of coexistence of depression with physical diseases such as diabetes, stroke, myocardial infarction, arthritis, asthma, thyroid disease, renal failure, and cirrhosis was significantly high. Conclusions ：In this study, the presence of chronic diseases greatly increased the risk of depression, and it was confirmed that certain groups were at high risk for depression.

Objectives: ：The aim of this study was to investigate the factors associated with changes in depression severity in index electroconvulsive therapy (ECT) for major depressive disorder. Methods: ：A retrospective analysis was performed on 80 patients with major depressive disorder who received index ECT. The severity of depression was assessed using the Hamilton depression rating scale-17 (HDRS-17). Multiple linear regression analysis and logistic regression analysis were performed to identify the factors associated with the change of depression severity and the predictors of the 50% or greater reduction rate of HDRS-17. Results ：55 (68.8%) patients were HDRS-17 score change ≥50% group, and 25 (31.2%) patients were HDRS-17 score change <50% group. HDRS-17 score change ≥50% group had a shorter episode duration before ECT (11.91±8.63 vs 17.68±11.15 weeks, p=0.027) and more ECT sessions (8.60±2.91 vs 6.80±3.34 sessions, p=0.017). The higher baseline score of anxiety (B=0.937, β=0.374, p<0.001), depression (B=0.846, β=0,324, p=0.001), and somatic symptom (B=0.995, β=0.210, p=0.031) dimensions was associated with the change of HDRS-17 score from baseline. The longer episode duration until the start of ECT was associated with lower likelihood of HDRS-17 score change ≥50% (Wald χ2 =7.74, OR=1.08, 95% CI: 1.02-1.14, p=0.005). The greater number of ECT sessions predicted the HDRS-17 score change ≥50% (Wald χ2 =7.85, OR=0.75, 95% CI=0.62-0.92, p=0.005) Conclusions：In higher baseline anxiety, depression, and somatic symptoms severity, implementing sufficient sessions of ECT in pharmacological treatment phase of relatively shorter duration of major depressive episode may help reduce HDRS-17 score.

Objectives: ：South Korea has one of the highest suicide rates in the world, with the highest rate reported in Busan metropolitan city in the past decade. Based on the data collected regarding the characteristics of suicide completers, we investigated gender- and age-related differences in the causes and methods of completed suicides. Methods: ：Information from 675 persons who committed suicide was included in the statistical analysis, and descriptive statistics were used to present the demographic variables. To ascertain the differences by gender and age, logistic regression analyses were also conducted. Age groups were stratified according to the stage in life: young, middle, and late adulthood. Additionally the odds ratios and 95% confidence intervals were estimated using gender and age as independent variables, and methods and causes as dependent variables. Results: ：The most frequent suicide method and cause were hanging and physical illness, respectively, with women were more likely to choose jumping as a suicide method than men. In terms of suicide causes, economic difficulties were more often related to men than women. While the young adulthood group was more likely to choose jumping and gassing than the late adulthood group, the latter was more likely to choose chemical poisoning as a suicide method.Furthermore, in terms of suicide causes, economic difficulty and psychiatric disorder were more often related to the young adulthood group than the late adulthood group. In addition, the middle adulthood group was more often associated with economic difficulty than the late adulthood group, while the latter was more often related with physical illness than the young adulthood group. Conclusions ：The causes and methods of suicide in suicide completers differ according to age and gender. The results of our study underline the need to reflect age- and gender-related characteristics in establishing suicide prevention policies.

Objectives: ：We investigated relationship between sleep time and depression in the aged 65 years or older. Methods: ：This study was based on the data from seventh Korean National Health and Nutrition Examination Survey (KNHANES). 3,285 people aged 65 years or older were selected as the subjects of this research. The demographic characteristics, sleep time and Patient Health Questinnaire-9 (PHQ-9) were administered for each subjects. Depression was defined as above 10 points of PHQ-9. Results: ：All the demographic variables such as age, sex, education, household income, marital status, drinking and smoking except Body Mass Index (BMI) were correlated with the depression. When we corrected the variables, inadequate sleep time groups (less than 6 hours or more than 9 hours) tended to be depressed. Conclusions ：The study results showed the significant correlation between sleep time and depression in the aged 65 years or older. Adequate sleep time is important to prevent the depression of the aged.

Objectives: ：Maltreatment is one of representative risk factor for psychiatric illnesses. While several studies indicate the relationship between physical activity and maltreatment, there was lack of study using objective measurements. This study was conducted to find the biomarkers of physical activity related to maltreatment experiences in healthy adults using wearable device. Methods: ：A total of 60 healthy adults were recruited; 15 subjects reported maltreatment experiences. Physical activity and sleep data were collected using Fitbit for 2 weeks. Child maltreatment experiences were assessed by Adverse Childhood Experiences (ACE). Symptoms were measured using the Insomnia Severity Index (ISI), Morningness-Eveningness Questionnaire (MEQ), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). Results: ：The child maltreatment group showed lower movement distance (p=0.025) and number of walks (p=0.010) compared to the control group. After controlling for anxiety and depressive symptoms in women, maltreatment group represented significant reduction in light activities (p=0.021) as well as movement distance (p=0.024) and number of walks (p=0.011). There was no significant difference in sleep variables between the two groups. Conclusions ：Even in healthy participants, maltreatment experiences can negatively affect daily light physical activity.

Objectives: ：This study aimed to investigate the prevalence of bullying behavior and its association with suicidal ideation among middle school students. Methods: ：This was a cross sectional study of a sample including 781 second grade middle school students(438 males and 343 females) in Gwang-ju metropolitan city. Information on bullying involvement, suicidal ideation and depressive/anxiety symptoms were collected using a self-administered questionnaire. Subjects were classified into subgroups of bully, victim, bully or victim, bully-victim, and witnessing. The data were analyzed using binary logistic regression analyses, adjusted for covariates. Results: ：The prevalence of bullying victimization, bullying perpetration, bullying witnessing and suicidal ideation were 26.5%, 24.5%, 21.6% and 26%, respectively. Suicidal ideation was positively correlated with bullying victimization, bullying perpetration, bullying witnessing. Using binary logistic regression analyses, the odds ratio of bully-victim group compared to non bullying involvement was 2.41, the highest among all groups. Conclusions ：Our findings indicate that school bullying, victim, and witnessing are associated with suicidal ideation, especially in bully and victim group. In addition, it is essential to develop prevention strategies and interventions for adolescents involved in any bullying involvement.