Growing body of evidence has suggested that bipolar disorder in the elderly is important issue of mental health care. While older bipolar patients show different clinical features and response to treatment compared to younger patients, there are few studies focused on the older bipolar patients. Authors reviewed clinical features and treatment issues for bipolar disorder in the elderly.
Aged ; Bipolar Disorder ; Humans ; Mental Health ; Mood Disorders

Schizophrenia is a chronic and debilitating mental disorder. The persisting negative and cognitive symptoms that are unresponsive to pharmacotherapy reveal the impairment of neuroprotective aspects of schizophrenia. In this review, of the several neuroprotective factors, we mainly focused on neuroinflammation, neurogenesis, and oxidative stress. We conducted a narrative and selective review. Neuroinflammation is mainly mediated by pro-inflammatory cytokines and microglia. Unlike peripheral inflammatory responses, neuroinflammation has a role in various neuronal activities such as neurotransmission neurogenesis. The cross-talk between neuroinflammation and neurogenesis usually has beneficial effects in the CNS under physiological conditions. However, uncontrolled and chronic neuroinflammation exert detrimental effects such as neuronal loss, inhibited neurogenesis, and excessive oxidative stress. Neurogenesis is also a major component of neuroprotection. Adult neurogenesis mainly occurs in the hippocampal region, which has an important role in memory formation and processing. Impaired neurogenesis and an ineffective response to antipsychotics may be thought to indicate a deteriorating course of schizophrenia. Oxidative stress and excessive dopaminergic neurotransmission may create a vicious cycle and consequently disturb NMDA receptor-mediated glutamatergic neurotransmission. Based on the current evidences, several neuroprotective therapeutic approaches have been reported to be efficacious for improving psychopathology, but further longitudinal and large-sample based studies are needed.
Adult ; Antipsychotic Agents ; Cytokines ; Drug Therapy ; Humans ; Memory ; Mental Disorders ; Microglia ; N-Methylaspartate ; Neurobehavioral Manifestations ; Neurogenesis ; Neurons ; Neuroprotection* ; Oxidative Stress ; Psychopathology ; Schizophrenia* ; Synaptic Transmission

OBJECTIVE: During the last two decades, Borna disease virus (BDV) has received much attention as a possible zoonotic agent, particularly as a cause of psychiatric disease. Although several studies have shown that BDV is present in Asia, BDV has not been detected in Korea. This study was designed to further investigate the presence of BDV infection in Korea. METHODS: Blood samples were taken from 39 race horses and 48 jockeys. Antibody to BDV was detected by indirect immunofluorescence antibody test and RNA of BDV by real time reverse transcriptase PCR (rRT-PCR). RESULTS: No evidence of BDV was detected in either the horses or the jockeys group. CONCLUSION: Our results suggest that BDV infection may not be endemic in Korea. Further studies with novel diagnostic tools are required to clarify the prevalence of BDV infection in Korea.
Animals ; Asia ; Borna Disease ; Borna disease virus ; Continental Population Groups ; Fluorescent Antibody Technique, Indirect ; Horses ; Humans ; Korea ; Prevalence ; Reverse Transcriptase Polymerase Chain Reaction ; RNA

OBJECTIVES: Disasters exert substantial effects on the mental health of victims and bereaved populations. Thus, a systematic framework for preparing and providing psychosocial and mental health services is necessary. The current attitudes toward and knowledge of disaster mental health-related factors among the general population provides one component for development of the disaster mental health services framework. METHODS: The authors analyzed a web-based survey for disaster mental health-related factors among the general population. Responses for the knowledge and perception for the disaster mental health services were compared between people who experienced and did not experience disaster. RESULTS: One thousand and three people completed the questionnaire. One hundred and seventy (16.9%) people experienced more than one disaster. People who experienced a disaster were more disturbed by disaster broadcasting or reporting than people who had not. People who experienced a disaster gave disaster mental health services an average score 63.5. People who experienced a disaster perceived group psychotherapy and self-help meetings as less important than those who had not. The recognition of both community mental health center and disaster mental health center was higher in the experienced group than non-experienced. CONCLUSION: This study revealed that general satisfaction with the current disaster mental health service is low, particularly among people who have used disaster mental health services. A national mental health system for disaster victims should be established with consideration for efficiency, effectiveness and accessibility.
Disaster Victims ; Disasters* ; Health Policy ; Mental Health Services* ; Mental Health* ; Psychotherapy, Group ; Public Health

Methylphenidate is a widely used stimulant for treatment of attention-deficit hyperactivity disorder (ADHD). In addition to core symptoms of attention and behavioral symptoms, methylphenidate is even effective for executive functions. However, abuse and misuse of stimulants, including methylphenidate, for the purpose of cognitive enhancement is an issue of concern worldwide. Some prejudices and misunderstandings against methylphenidate are popular ; however, little attention has been given to the neuropsychiatric evidence of methylphenidate for enhancement of cognitive function among healthy populations. In this article, our aim was to conduct a review of previous studies investigating the effect of methylphenidate in healthy populations. Findings from several recent studies have demonstrated the effectiveness of methylphenidate for enhancement of cognitive function in healthy populations. The mechanisms of cognitive enhancement are thought to be associated with motivation and the reward circuit in the brain. However, when considering the risk to benefit, an official discussion of the use of methylphenidate among healthy members of the population would be premature. Instead, investigation of epidemiological studies of the prevalence of misuse of stimulants among healthy members of the population, particularly adolescents and college students, is needed. In addition, based on achievements reported in previous studies, investigation of the effect of an approach using non-pharmacological enhancing motivation, which will in turn result in increased cognitive function would be helpful.
Achievement ; Adolescent ; Behavioral Symptoms ; Brain ; Executive Function ; Humans ; Learning ; Methylphenidate ; Motivation ; Prejudice ; Prevalence ; Reward

Objective: Schizophrenia-spectrum disorders and posttraumatic stress disorder (PTSD) share common clinical manifestations, genetic vulnerability, and environmental risk factors. We aimed to conduct a systematic review and meta-analysis of the comorbid prevalence of PTSD among schizophrenia-spectrum disorders. Methods: We performed a meta-analysis to identify possible contributing factors to the heterogeneity among these studies. We systematically searched electronic databases with no restrictions on language of articles. Results: We extracted 24 samples (18 for current prevalence and 6 for lifetime prevalence) from 22 studies and used a random effects model to estimate the pooled prevalence of PTSD among schizophrenia-spectrum disorders. The current and life prevalence of comorbid PTSD was 10.6% (95% confidence interval [CI]=6.3%–17.3%) and 13.0% (95% CI=5.3%–28.6%), respectively. Studies assessing psychotic experiences/involuntary admission reported the highest prevalence of comorbid PTSD (57.1%, 95% CI=43.6%–59.7%), whereas those assessing various anxiety disorders reported the lowest prevalence (1.1%, 95% CI=1.0%–5.5%). Heterogeneities of the subgroup analysis by similar objectives were largely homogeneous (I2=7.1–34.1). In the qualitative assessment, only two studies (9.1%) were evaluated as having a low risk of bias. Conclusion Our results showed that a careful approach with particular attention to assessing PTSD is essential to reliably estimate the prevalence of PTSD comorbid with schizophrenia-spectrum disorders. The reason for the wide discrepancy in the prevalence of comorbid PTSD among the four groups of studies should be addressed in future research.

Psychological autopsy is a systematic methodology for comprehensive investigation of psychiatric and behavioral factors assumed to be causative or related to death of the deceased. In many countries, psychological autopsy is considered the most direct and valuable tool for determining the relationship between risk factors and suicide. The case of Finland revealed that successful psychological autopsy studies could greatly contribute to the national suicide prevention strategy, which consequently reduced the national suicide rate. Despite the strengths of psychological autopsy for identifying risk factors of suicide and consequently preventing suicide, it has not been successful in Korea. Implementation of psychological autopsy has been inconsistent and sporadic across the provinces. In addition, standardization of psychological autopsy protocol and qualification of interviewers are needed. With all of these methodological issues in mind, conduct of as many psychological autopsies as possible is important in order to build an evidence-based suicide prevention strategy. For successful implementation of psychological autopsy in Korea, it is necessary to improve attitudes toward suicide and psychiatric conditions. Legal, administrative, and institutional support are also important. Finally, multidisciplinary approach based on the financial and legal support should be employed.
Autopsy* ; Finland ; Korea ; Mental Health ; Risk Factors ; Suicide

OBJECTIVES: To examine the association of subjective depressive symptoms and cognitive dysfunction in patients with mild traumatic brain injury (mTBI). METHODS: 36 patients with mTBI without structural abnormality in the brain imaging study were recruited. Participants were subdivided into two groups by a cutoff score of 70T in the Beck Depression Inventory (BDI). Cognitive functions including intelligence, memory, and executive function were significantly lower in the <70T group compared to the > or =70T group. In addition, BDI scores were negatively correlated with performances in most of the neuropsychological tests. RESULTS: Patients group who scored 70T or more in the BDI showed significantly lower scores in most items of the neuropsychological tests. CONCLUSION: High subjective depression is associated with low neuropsychological performance in mTBI.
Brain Injuries ; Depression ; Executive Function ; Humans ; Intelligence ; Memory ; Neuroimaging

OBJECTIVE: Mild traumatic brain injury (mTBI) is frequently associated with psychiatric symptoms and cognitive dysfunction, as well as with the receipt of workers' compensation, as many mTBIs occur due to work-related accidents. We hypothesized that depression and insufficient cognitive effort mediate the relationship between sociodemographic variables and cognitive dysfunction in mTBI. METHODS: A retrospective chart review study was conducted using 115 records of patients with mTBI. Cognitive effort was measured based on scores on the Rey 15-Item Test. Multivariate linear regression analysis was performed to examine factors predictive of cognitive functions. Path analysis was subsequently performed to investigate the mediating effects of depression and cognitive effort in relation to receipt of workers' compensation and demographic variables. RESULTS: Fifteen of the 115 participants (13.0%) received failing scores on the Rey 15-Item Test, which indicated insufficient cognitive effort. Path analysis indicated that cognitive effort mediated the effects of age and workers' compensation on cognitive functions. CONCLUSION: Given the significant mediating effects of cognitive effort on cognitive performance, it is important to address patient motivation and encourage mTBI patients covered by workers' compensation to perform tests with authentic effort.
Brain Concussion ; Brain Injuries* ; Compensation and Redress ; Depression* ; Retrospective Studies ; Executive Function* ; Humans ; Intelligence* ; Linear Models ; Memory* ; Motivation ; Negotiating* ; Neuropsychological Tests ; Workers' Compensation

Mental health policy influences the mental health system and promotion in the medium and longer term. Thus, many countries develop a mental health plan suitable for their countries. In 2012, the suicide rate in Korea was 28.1 per 100000 persons, representing a nine-year high among countries in the Organization for Economic Co-operation and Development. In addition, suicide rates in Korea increase as a function of age. For example, the prevalence of suicide per 100000 persons is 19.3 among people in their 20 s and 83.2 among those in their 70 s, respectively. Another important mental health issue in Korea is a need for 'positive psychiatry', which generally aims to improve mental health and psychiatric conditions, not only in patients with psychiatric illnesses but also in the general population. As the definition of mental health is being broadened, psychiatrists should expand their range of activities and collaborate more with other professional and civic groups. Psychiatrists belonging to various institutions, such as mental health groups, clinics, mental health hospital, and general hospital, also need to find ways to expand the importance of their roles. Given the growing responsibilities for the mental health policy, the Policy Research Institute of the Korean Neuropsychiatric Association planned eight review articles on the mental health of Korea in the medium and longer term.
Academies and Institutes ; Health Policy ; Health Promotion ; Hospitals, General ; Humans ; Korea ; Mental Health ; Prevalence ; Psychiatry ; Suicide