Schizophrenia is one of serious mental illnesses and is often described as a heterogeneous disorder. Approximately one-third of schizophrenia cases are treatment-resistant schizophrenia (TRS). The aim of this study was to review the definitions and clinical features of TRS. Though it was found that the criteria for TRS were considerably diverse, the Treatment Response and Resistance in Psychosis (TRRIP) consensus criteria were recently introduced. According to the TRRIP criteria, TRS should be suspected if symptoms persist alongside psychotic symptoms despite sufficient treatment for ≥12 weeks, or two or more symptoms persist significantly for ≥6 weeks. The clinical characteristics of TRS includes an earlier age of onset, more severe and familial form, possibly more rural residence, unlikely association with male sex, and an increase in cognitive deficits.

The Mental Health Act of 1995 was fully revised on May 29, 2016, and implemented on May 30, 2017, under the name of the Mental Health Promotion and Mental Health Service Support Act (Mental Health Welfare Act). The act newly defined mentally ill people as those with significant limitations in independent daily life and reduced their classification based on severity. Before the revision, patients could be admitted to the hospital if satisfied with the risk of self-injury or harm to others or the need for treatment. The self-injury and harm to others risk criteria for involuntary admission is based on the idea of respecting patients’ right to self-determination. However, predicting future risks can be challenging, and the situation at the time of judgment should be considered. This study aims to examine the administrative and legal interpretation of the self-injury or harm to others risk for involuntary admission, review definitions and evaluations of the risk of self-harm in various areas, and suggest improvements for mental health policies or guidelines.

OBJECTIVES: The Young's internet addiction test (IAT) is used worldwide, and the psychometric properties of IAT have been documented in other countries. The aim of this study was to evaluate and validate the factors and structure of the IAT as applied to Korean college students. METHODS: Data was collected from students (n=2216) at Kongju National University via an online survey system. The factor structures of the IAT were assessed using exploratory and confirmatory factor analysis. RESULTS: The IAT produced acceptable internal consistency and reliability (Cronbach alpha=0.921). We discovered that the two-factor structure of the IAT produced acceptable psychometric properties. Factor 1 consisted of the aspiration and obsession to achieve orientation in cyberspace, Factor 2 consists of loss of control, withdrawal, and neglect of social interaction and duties. These findings were inconsistent with those of previous studies. There were no significant gender differences observed in internet addiction rates. CONCLUSION: IAT is a reliable scale which identifies two internet addiction factors in Korean college students. This scale could be useful to quantitatively evaluate internet addiction.
Factor Analysis, Statistical ; Humans ; Internet ; Interpersonal Relations ; Obsessive Behavior ; Orientation ; Psychometrics

OBJECTIVES: The Beck Depression Inventory (BDI) is one of the most widely used self-report measures of depression in both research and clinical practice. The Beck Depression Inventory Second Edition (BDI-II) is the most recent version of the BDI. Validity of the BDI-II has been documented in other countries. This study examined the factor structure of the Korean version of BDI-II in a large sample of university students. METHOD: Data were obtained from 2,529 students of Kongju National University. The factor structures of the Korean version of BDI-II were assessed using exploratory and confirmatory factor analysis. RESULTS: A high level of internal consistency and reliability (Cronbach's alpha = 0.91) and item homogeneity was confirmed. Exploratory factor analysis showed a two-factor structure (cognitive and somatic-affective), which was almost identical to the original model demonstrated by Beck et al. The following confirmatory factor analysis also supported the two-factor structure (cognitive and somatic-affective) is a better fit than the other two-factor structure (cognitive-affective and somatic). The higher mean score for women compared to men is consistent with the results of previous reports. CONCLUSION: These data support the reliability and concurrent validity of the Korean version of BDI-II as a measure of depressive symptoms in nonclinical samples.
Depression ; Female ; Humans ; Multiple Endocrine Neoplasia Type 1

Objective: Gambling disorder (GD) patients have a higher suicide risk compared to the general population. The present study investigates the suicide-related risk factors of GD patients by analyzing GD diagnosis-related symptoms and suicide-related behaviors of subjects. Methods: This study investigated which symptoms among GD diagnosis criteria are related to suicide risk in 142 patients diagnosed with GD. To analyze the relationship between GD symptoms and suicidal ideation and suicide attempt, the odds ratio (OR) was determined through multivariate logistic regression. Results: The number of symptoms was significantly higher in the subjects who had suicidal ideation group and attempt group. In the cases of past suicide attempts, responses to withdrawal and escape questions were significantly higher; in the cases of ongoing suicidal ideation, responses to negative consequences and bailout questions were significantly higher. When depression was corrected, the ‘bailout’ item was, indicating that ‘bailout’ increased suicidal ideation (OR=4.937, 95% CI=1.009–24.164). In the suicide attempt group, ‘relieve’ item may increase suicide attempt (OR=6.978, 95% CI=1.300–35.562). Conclusion Past suicide attempts in GD patients correlated with withdrawal symptoms, and financial problem correlated with suicidal ideation. This suggests that evaluating suicide risk is important when evaluating GD patients, and evaluation of financial problems is important for GD patients with suicide risks.

BACKGROUND: To further understand the relationship between anxiety and depression, this study examined the factor structure of the combined items from two validated measures for anxiety and depression. METHODS: The participants were 406 patients with mixed psychiatric diagnoses including anxiety and depressive disorders from a psychiatric outpatient unit at a university-affiliated medical center. Responses of the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI)-II, and Symptom Checklist-90-Revised (SCL-90-R) were analyzed. We conducted an exploratory factor analysis of 42 items from the BAI and BDI-II. Correlational analyses were performed between subscale scores of the SCL-90-R and factors derived from the factor analysis. Scores of individual items of the BAI and BDI-II were also compared between groups of anxiety disorder (n = 185) and depressive disorder (n = 123). RESULTS: Exploratory factor analysis revealed the following five factors explaining 56.2% of the total variance: somatic anxiety (factor 1), cognitive depression (factor 2), somatic depression (factor 3), subjective anxiety (factor 4), and autonomic anxiety (factor 5). The depression group had significantly higher scores for 12 items on the BDI while the anxiety group demonstrated higher scores for six items on the BAI. CONCLUSION: Our results suggest that anxiety and depressive symptoms as measured by the BAI and BDI-II can be empirically differentiated and that particularly items of the cognitive domain in depression and those of physical domain in anxiety are noteworthy.
Anxiety Disorders ; Anxiety* ; Depression* ; Depressive Disorder ; Diagnosis ; Factor Analysis, Statistical* ; Humans ; Outpatients*

The Seasonal Affective Disorder (SAD) is a disorder characterized by prolonged periods of depression and various physical and psychological symptoms experienced during specific seasons, typically winter. In this review aims to provide a comprehensive overview of SAD with a specific focus on psychophysiological aspects. Through the review from ancient times to the present, this paper explores the characteristics, causes, and underlying mechanisms of SAD. Particularly, it comprehensively reviews the research findings on the relationship between external factors such as light, sunlight, climate, and their association with SAD.Furthermore, the paper discusses the interplay between SAD and psychophysiological changes, along with the latest research trends in treatment and prevention strategies. By combining theoretical and practical perspectives on SAD, this article aims to provide a holistic understanding and offer suggestions for future research directions and clinical interventions.

OBJECTIVES: In previous studies, both temperament and character were known as an important factor to determine the extent of social support. The purpose of this study was to evaluate effects of temperament and character on social support. METHODS: A total 4329 participants completed questionnaires, which included Lubben Social Network Scale (LSNS), Temperament and Character Inventory (TCI). This study used Pearson's correlation to evaluate the correlation between TCI dimensions and LSNS. To find the most influential TCI dimension for LSNS, multiple regression analysis was performed for this study. RESULTS: TCI dimensions showed significant mean differences depending on gender (p<0.001). LSNS had highest positive correlation with reward dependence (r=0.357, p<0.001). Three dimensions of TCI (Persistence, Self-Directedness, Cooperativeness) had positive correlation with LSNS (p<0.001). Harm avoidance had negative correlation with LSNS (r=-0.237, p<0.001). According to the results of the multiple regression analysis, reward dependence is the most influential TCI dimension (beta=0.261, t=15.963, p<0.001). CONCLUSION: This result shows that social support is affected by properties of temperament and character. Therefore, to measure properties of temperament and character will help to assess social support.
Humans ; Surveys and Questionnaires ; Reward ; Temperament

OBJECTIVES: The interpersonal support evaluation list-12 (ISEL-12) is one of the scales used for measurement of perceived social support. This study standardized self-report social support measure, ISEL-12. METHODS: Participants included 294 students of a university. Convergent validity was assessed by correlating scores on the ISEL-12 with those on other scales. A exploratory factor analysis was performed to determine the factor structure of the ISEL-12. RESULTS: ISEL-12 showed acceptable reliability and validity. High level of internal consistency and reliability (Cronbach alpha=0.866) and item homogeneity was confirmed. We found two-factor structures of ISEL-12 via factor analysis. The Korean version of ISEL-12 showed significant correlation with other scales for evaluation of perceived social support. Test-Retest reliability was also confirmed (Pearson's correlation coefficient=0.65). CONCLUSION: These findings support the reliability and validity of the Korean version of ISEL-12 for evaluation of perceived social support in young adults.
Humans ; Reproducibility of Results ; Weights and Measures ; Young Adult

The suicide risk of patients with schizophrenia is about 8.5-fold greater than that of the general population. Since 4-13% of patients with schizophrenia commit suicide, and 25-50% attempt suicide at least once during their lifetime, suicide can be a main cause of their higher mortality rate as compared with that of the general population. While evidence suggests that previous depressive disorders, previous suicide attempts, drug misuse, agitation or motor restlessness, fear of mental disintegration, poor adherence to treatment, and recent loss of another person are associated with the increased risk of suicide in schizophrenia, hallucinations have been associated with decreased suicide risk. Despite there being at least modest evidence suggesting that antipsychotics protect against suicidal risk, clozapine has been shown to be the most favorable second-generation antipsychotic for preventing suicide in patients with schizophrenia. In addition, selective serotonin receptor inhibitors can ameliorate suicidal ideation in schizophrenia. Furthermore, individual psychosocial interventions and psychotherapy, and reducing stigma, can be integral strategies for the prevention of suicide in schizophrenia. Further study is needed to identify the epidemiological characteristics and clinical correlates of suicide in Korean patients with schizophrenia, and provide an effective strategy for its prevention in Korea.
Antipsychotic Agents ; Clozapine ; Depressive Disorder ; Dihydroergotamine ; Hallucinations ; Humans ; Korea ; Mortality ; Psychomotor Agitation ; Psychotherapy ; Schizophrenia* ; Serotonin ; Suicidal Ideation ; Suicide*