OBJECTIVE: Traumatic syndromes resembling posttraumatic stress disorder (PTSD) have been repeatedly described through the history of mankind. Since the inclusion into operational criteria of DSM-III, the concept of PTSD have been robustly changed. The author reviewed the cutting-edge issues regarding diagnosis and pathophysiology of PTSD for proper understanding of this conditon. METHODS: Wide literatural reviews using Medline and texbooks were performed for integrating up-to-date findings of PTSD studies. Several own preliminary findings and discussions with world-wide experts were also included into this review. RESULTS: The complex pathophysiology with the concept of "stress-vulnerablity model" of PTSD has become increasingly important as the dianostic criteria for PTSD specify an etiological factor, namely the traumatic event, unlike most other mental disoders. The present paper diffusely reviewed the historical consideration, the change of disease concept, symptomatology, diagnosis, differential diagnosis, methods for assessment, epidemiology, and pathophysiology of PTSD. CONCLUSION: Since various traumatic events are very prevalent in Korea, understanding the clinical phenomenology of PTSD is very crucial to properly diagnose and treat patients with PTSD.
Diagnosis* ; Diagnosis, Differential ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiology ; Humans ; Korea ; Stress Disorders, Post-Traumatic

OBJECTIVE: Traumatic syndromes resembling posttraumatic stress disorder (PTSD) have been repeatedly described through the history of mankind. Since the inclusion into operational criteria of DSM-III, the concept of PTSD have been robustly changed. The author reviewed the cutting-edge issues regarding diagnosis and pathophysiology of PTSD for proper understanding of this conditon. METHODS: Wide literatural reviews using Medline and texbooks were performed for integrating up-to-date findings of PTSD studies. Several own preliminary findings and discussions with world-wide experts were also included into this review. RESULTS: The complex pathophysiology with the concept of "stress-vulnerablity model" of PTSD has become increasingly important as the dianostic criteria for PTSD specify an etiological factor, namely the traumatic event, unlike most other mental disoders. The present paper diffusely reviewed the historical consideration, the change of disease concept, symptomatology, diagnosis, differential diagnosis, methods for assessment, epidemiology, and pathophysiology of PTSD. CONCLUSION: Since various traumatic events are very prevalent in Korea, understanding the clinical phenomenology of PTSD is very crucial to properly diagnose and treat patients with PTSD.
Diagnosis* ; Diagnosis, Differential ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiology ; Humans ; Korea ; Stress Disorders, Post-Traumatic

OBJECTIVES: This study aims to develop a Korean version of the Composite International Diagnostic Interview(K-CIDI). METHODS: The Composite International Diagnostic Interview(CIDI) is a comprehensive, fully standardized interview that can be used to assess psychiatric disorders and provide diagnoses. The K-CIDI was developed according to the guidelines provided by the WHO. The reliability and validity of the K-CIDI was evaluated by examining 135 psychiatric patients and five community residents. Subjects were jointly interviewed twice with a one-week interval. A psychiatric resident and clinical psychologist jointly determined clinical diagnoses using the Structured Clinical Interview for DSM-IV. RESULTS: Notable modifications were done in sex-related expression, health system and help-seeking behavior, subjects for phobic disorder, and kinds of alcohol and substance. Long and complex questions were divided into two or more questions. Field test and back-translation of the K-CIDI confirmed the appropriateness of the translation of the CIDI. The inter-rater reliability, test/retest reliability, and validity of the K-CIDI indicated kappa values ranging from 0.86-1.00, 0.42-0.89, and 0.50-1.00, respectively. CONCLUSION: The K-CIDI was deemed to be appropriate for the sociocultural background of Koreans. The reliability and validity of the K-CIDI were judged to be exceptionally acceptable.
Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiology ; Humans ; Phobic Disorders ; Psychology ; Reproducibility of Results

To determine the impact of Cysticercus cellulose (C. cellulose) infection on mental health among school-aged children in Tibetan agricultural areas of Sichuan Province.
 Methods: In October 2015, all primary schools located in Tibetan agricultural areas in Yajiang, Ruoergai, and Muli county of Sichuan Province were selected as the research sites. All school-aged children at five- and six-grade were enrolled for the study by a multistage stratified cluster sampling method. Antibodies against C. cellulose were detected. Mental Health Test and questionnaire survey were conducted for school-aged children to collect data. The impact of C. cellulose infection on mental health among school-aged children was analyzed with the multilevel linear regression.
 Results: A total of 2 453 school-aged children were investigated. The C. cellulose seropositive rate was 6.03% (148/2 453). There were 0.16% (4/2 453) patients with seropositive accompanied by seizure, 2.28% (56/2 453) with seropositive accompanied by headache, 2.08% (51/2 453) with seropositive accompanied by frequent weak, and 0.41% (10/2 453) were seropositive accompanied by frequent nausea. The rate of C. cellulose infection was 4.53% (111/2 453). The mean score of the mental health test was 6.59±2.61. There were significant difference in score of mental health test in children whose demographic characteristics were different. The mental health scores of school-aged children were clustered at the school level. After controlling the factors of demographic characteristics, the result of multilevel model demonstrated that the factor of school-aged children with C. cellulose seropositive accompanied by headache was statistically significant (β=1.14, P=0.017).
 Conclusion: The status of C. cellulose infection among school-aged children in Tibetan agricultural areas is not optimistic. C. cellulose infection has impacted on mental health of local school-aged children. It is necessary to strengthen the prevention and control of C. cellulose infection in epidemic area.
Animals ; Child ; Cysticercosis ; complications ; diagnosis ; epidemiology ; Cysticercus ; Humans ; Mental Health ; Neurodevelopmental Disorders ; epidemiology ; etiology ; Seroepidemiologic Studies ; Tibet ; epidemiology

OBJECTIVES: The aim of the study was to develop a North Korean version of the Composite International Diagnostic Interview (NK-CIDI) and to evaluate the reliability and validity of NK-CIDI. METHODS: Subjects were 100 North Korean defectors, aged 18 to 65, who were recruited in a center for defectors in the National Medical Center or who were on an education curriculum in the defector settlement support center. NK-CIDI was developed based on the Korean version of CIDI considering the sociocultural background of North Korea. Inter-rater reliability, test/retest reliability, and validity of NK-CIDI were evaluated and kappa value was calculated. RESULTS: Different vocabularies and awkward expressions were adjusted, and additional explanations were supplemented for difficult phases. The target for development of NK-CIDI was early defectors who entered South Korea less than 3 months ago. Inter-rater reliability (n=30, kappa value 0.35-1.00), test/retest reliability (n=30, kappa value 0-0.86), and diagnostic validity (n=100, kappa value -0.02-0.42) were evaluated. CONCLUSION: Compared to the general population, defectors experience more psychiatric issues, and a standardized tool for diagnosis is needed. In this study, NK-CIDI was developed and the results suggest that reliability is acceptable but validity needs further verification. NK-CIDI could be utilized in future epidemiologic studies.
Curriculum ; Democratic People's Republic of Korea ; Diagnosis ; Education ; Epidemiology ; Korea ; Mental Disorders ; Reproducibility of Results ; Vocabulary

OBJECTIVES: One of the objectives of this study is to estimate the prevalence rates of psychiatric diagnoses in the combined populations of psychiatric hospitals, psychiatric nursing facilities and homeless asylums using the Korean version of the Composite International Diagnostic Interview (K-CIDI), which is a comprehensive and fully standardized interview schedule to assess psychiatric disorders for diagnosis. The Other objective is to compare with previously studied prevalence rates of psychiatric diagnoses using the results of this study. METHODS : The study subjects, aged from 18 to 64 years, were randomly selected from 64,582 institutionalized population of psychiatric hospitals, psychiatric nursing facilities and homeless asylums as of 30, June, 2001. Twelve trained interviewers administered the K-CIDI to the selected respondents. A total of 1,875 respondents (male 1,194, female 681) completed the interview. RESULTS : The lifetime and one year prevalences of any diagnosis excluding nicotine dependence. withdrawal, anxiety disorder, eating disorder, somatoform disorder were 88.2% (male 88.1%, female 88.3%), and 65.8% (male 62.7%, female 73.7%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were 78.5% (male 75.3%, female 83.7%), and 56.8% (male 51.9%, female 64.8%), respectively. The lifetime and one year prevalences of alcohol use disorder (dependence/abuse) were 26.7% (male 37.9%, female 8.3%), and 8.7% (male 12.8%, female 2.1%), respectively. The lifetime and one year prevalences of mood disorder were 18.1% (male 13.5%, female 25.8%), and 10.4% (male 7.2%, female 16.9%), respectively. The lifetime and one year prevalences of schizophrenia and other psychotic disorders were comparable with the 2001 community survey by 1.19% to 1.32%, and 0.51% to 0.61%, respectively. The lifetime and one year prevalences of schizophrenia were also comparable by 0.16% to 0.28%, and 0.16% to 0.25%, respectively. There were no significant changes of prevalence rates when correction were applied to other psychiatric diagnosis. CONCLUSION : The results of this study could be used for evaluating the distribution of psychiatric diagnoses in mental health related facilities and for planning mental health policies.
Anxiety Disorders ; Appointments and Schedules ; Surveys and Questionnaires ; Diagnosis ; Feeding and Eating Disorders ; Epidemiology ; Female ; Hospitals, Psychiatric ; Humans ; Mental Disorders* ; Mental Health* ; Mood Disorders ; Prevalence* ; Psychiatric Nursing ; Psychotic Disorders ; Schizophrenia ; Somatoform Disorders ; Tobacco Use Disorder

Studies indicate that sleep problems in children and adolescents are highly prevalent, with prevalence rates ranging from 25% to 40%. They are even more common in special populations, especially children with psychiatric issues. Furthermore, sleep issues are often persistent. Unfortunately, sleep disturbances often do not receive the attention that they deserve, especially since they are often highly amenable to intervention. Sleep problems, in general, range from those that are physiologically-based, such as obstructive sleep apnoea and restless legs syndrome, to those that are behaviorally-based. The behaviourally-based sleep disorders are reviewed, including a discussion of assessment, prevalence and treatment. Non-pharmacologic approaches are usually the preferred treatment and have received the most empirical support in paediatric populations. It is strongly recommended that all paediatric healthcare providers consider sleep issues in their comprehensive assessment of all children and adolescents, especially those with psychiatric issues, and provide preventive education as part of their usual standard of care.
Adolescent ; Arousal ; Behavior Therapy ; Child ; Comorbidity ; Humans ; Medical History Taking ; Mental Disorders ; epidemiology ; Sleep Disorders, Circadian Rhythm ; epidemiology ; Sleep Initiation and Maintenance Disorders ; epidemiology ; Sleep Wake Disorders ; diagnosis ; epidemiology ; physiopathology ; therapy

The purpose of this study was to evaluate the associations between weight status and mental disorders, including depressive disorder, anxiety disorder and alcohol use disorder. A total of nationally representative 6,510 subjects aged 18-64 yr was interviewed in face-to-face household survey. Response rate was 81.7%. Mental disorders were diagnosed using the Korean version of the Composite International Diagnostic Interview (K-CIDI). The subjects reported their heights and weights. After adjusting for age and gender, the lifetime diagnosis of depressive disorder had a significant association with only the underweight group (odds ratio [OR], 1.68, 95% confidence interval [CI], 1.19-2.38). The association between underweight and depressive disorder was the strongest for subjects with a high education level (OR, 1.75, 95% CI, 1.2-2.56), subjects with a married/cohabiting status (OR, 1.94, 95% CI, 1.17-3.22) and smokers (OR, 2.58, 95% CI, 1.33-4.98). There was no significant association between obesity and depressive disorder in Korea. But there was a significant association between the underweight group and depressive disorder. The relationship between obesity and mental disorder in a Korean population was different from that in a Western population. These results suggest that the differences of traditional cultures and races might have an important effect on the associations between the weight status and mental disorders.
Adolescent ; Adult ; Alcohol-Related Disorders/diagnosis ; Anxiety Disorders/diagnosis ; *Body Weight ; Depressive Disorder/diagnosis ; Female ; Humans ; Interviews as Topic ; Male ; Mental Disorders/diagnosis/*epidemiology ; Middle Aged ; Obesity/diagnosis/epidemiology ; Odds Ratio ; Republic of Korea ; Risk Factors ; Thinness

OBJECTIVE: Depression in the elderly is a major health concern that can be life threatening if not recognized and treated. Despite considerable interest, there in no consensus regarding the prevalence of depression in later life. This study was aimed to investigate the prevalence of major depressive disorder in the population over age 65 years and provide fundamental data for community mental health programs. METHOD: 500 elderly people aged over 65 years and oner in Kwachon were interviewed according to DSM-IV and examined Geriatric Depression Scale(GDS), Korea Depression Scale(KDS), MMSE-K, Korea-Dementia Rating Scale(K-DRS), etc. by trained researchers. RESULTS: Of the sample, prevalence of mild, moderate and severe depressive symptoms are 18.8%, 7.4%, and 17.8%, respectively. Prevalence of major depressive disorder is found to be 7.8%. There is no significant differences between depressive & non-depressive groups in the sociodemographic variables such as sex, age, education, family type, etc. Major depressive disorder is associated with physical illness, stressful life events, and cognitive dysfunction. CONCLUSION: The results showed similar prevalence rates to other epidemiological studies. Depressed group showed more psychological distress, stressful life events and cognitive dysfunctions than non-depressed group. Accurate and early diagnosis and adequate treatment favor a good prognosis.
Aged ; Consensus ; Depression* ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Early Diagnosis ; Education ; Epidemiologic Studies* ; Epidemiology ; Gyeonggi-do ; Humans ; Korea* ; Mental Health ; Prevalence ; Prognosis

INTRODUCTIONAnorexia nervosa (AN) and eating disorders not otherwise specified (EDNOS) are on the rise in Singapore. Abnormal liver function tests have been reported for up to 12.2% of patients with AN. These patients are also known to present with comorbid psychiatric disorders. This study aims to investigate the correlation between body mass index (BMI) and the severity of abnormal liver function tests, and between BMI and the presence of comorbid psychiatric disorders.

METHODSA retrospective cohort analysis of 373 patients diagnosed with AN or EDNOS at a tertiary hospital was performed. The clinical course of transaminitis and comorbid psychiatric disorders was correlated with the patient's BMI.

RESULTSPatients with a BMI of ≥ 16.6 kg/m(2) at their first consult had a significantly lower risk of having comorbid psychiatric disorders (χ(2) = 32.08, p < 0.001). These patients were five times less likely to have comorbid psychiatric disorders as compared to patients from the other BMI groups (odds ratio [OR] 0.21). On the other hand, patients with a BMI of < 14.6 kg/m(2) had a significantly higher risk of having transaminitis (χ(2) = 72.5, p < 0.001). They were 11.1 times more likely to develop transaminitis as compared to patients with a BMI of ≥ 14.6 kg/m(2) (OR 11.05).

CONCLUSIONSeverity of BMI can be used by clinicians as an indicator to assess for secondary psychiatric comorbidities and/or transaminitis during the first consultation. This could help reduce the morbidity and mortality rates in patients with AN or EDNOS.

Adolescent ; Adult ; Alanine Transaminase ; blood ; Alkaline Phosphatase ; blood ; Anorexia Nervosa ; complications ; diagnosis ; epidemiology ; Aspartate Aminotransferases ; blood ; Body Mass Index ; Child ; Comorbidity ; Diagnostic and Statistical Manual of Mental Disorders ; Feeding and Eating Disorders ; complications ; diagnosis ; epidemiology ; Female ; Humans ; Liver Diseases ; complications ; diagnosis ; epidemiology ; Liver Function Tests ; Male ; Mental Disorders ; complications ; diagnosis ; epidemiology ; Odds Ratio ; Prevalence ; Psychiatric Status Rating Scales ; Retrospective Studies ; Singapore