OBJECTIVES: Insufficient sleep could have harmful effects on mental health. We examined the mental health status of Korean adolescents according to daily sleep time and subjective sleep satisfaction using a nationwide representative sample of Korean adolescents. METHODS: Data from the 2016 Korean Youth Risk Behavior Web-based Survey was used. Sleep duration on weekdays and subjective sleep satisfaction during the past week were asked. Participants' perceived health, happiness, stress, depressive mood, and suicidality during past 12 months were also investigated. Participants were classified by mean duration of daily sleep time and the level of sleep satisfaction, and the odds of having mental health problems were compared. RESULTS: Compared to adolescents who slept more than 6 hours per day and satisfied with their sleep, adolescents who slept less than 6 hours per day and/or dissatisfied with their sleep were less likely to perceive themselves healthy and happy. They were also more likely to have severe stress, depressive mood, and suicidality, with highest odds ratios among adolescents with both short and dissatisfying sleep. CONCLUSIONS: Given the significant associations between sleep insufficiency and mental health problems, attention to the sleep shortage among Korean adolescents is needed. Prospective studies are warranted to elucidate the causal relationships between subjective and objective sleep insufficiency and psychiatric conditions.
Adolescent ; Depression ; Happiness ; Humans ; Mental Health ; Odds Ratio ; Prospective Studies ; Risk-Taking ; Suicidal Ideation

Objective: Alcohol use disorder (AUD) is a global burden but is also one of the most undertreated mental disorders. This study estimates the treatment rate (i.e., help-seeking status) of high-risk drinkers and factors associated with not receiving treatment in Korea using nationally representative National Health Insurance Service-National Sample Cohort (NHIS-NSC) data. Methods: Among 1,025,340 participants, we eliminated those under 20 and those who did not respond to the question regarding alcohol consumption. High-risk drinkers were classified based on their frequency and quantity of alcohol consumption (4 or more drinks for women, 5 or more drinks for men per day on average). In total, 32,225 high-risk drinkers were checked for an actual AUD diagnosis to see their treatment-seeking status. Results: Among 32,225 high-risk drinkers, only 1.24% had an AUD diagnosis, showing that over 98% of those who could be diagnosed with AUD are not seeking treatment. Factors associated with not seeking treatment were female sex, BMI higher or equal to 18.6, former smoker, middle-aged, and Charlson Comorbidity Index (CCI). Conclusion Our data show that many high-risk drinkers do not seek treatment in Korea. Experts, policymakers, and clinicians should promote help-seeking behavior for AUD and pay close attention to those at risk of not receiving treatment for AUD.

Objective: The objective of this study was to monitor the trend of psychiatric visits and medication prescriptions among people tested for SARS-CoV-2 during the initial phase of coronavirus disease 2019 (COVID-19) pandemic in South Korea. Methods: We conducted a population-based cohort study using data from the National Health Insurance Service (NHIS) linked to the Korea Disease Control and Prevention Agency (KDCA) data. The overall trend of psychiatric visits during COVID-19 for each month was compared to the month prior to COVID-19. The number of psychiatric medication prescription records was monitored from January 2019 to May 2020. Results: A total of 212,678 individuals were tested for SARS-CoV-2 between January 2020 and May 2020. Among these individuals, 72.1% (n=153,309) did not have pre-existing mental illness, and 27.9% (n=59,369) had pre-existing mental illness. We found that most psychiatric visits were made in March, and patients without pre-existing mental illness significantly increased in psychiatric outpatients during the COVID-19 pandemic (p trend<0.001). In addition, psychiatric medication prescriptions were the most prescribed between March and April 2020. Conclusion We identified a rising trend in psychiatric visits and medication prescriptions among people who were tested for SARSCoV-2 during the initial phase of COVID-19 pandemic in South Korea.

Objective: To investigate the cumulative effect of antipsychotics at different dosages on mortality in patients with schizophrenia. Methods: We analyzed data from the Korean National Health Insurance System−National Sample Cohort covering the 2002−2013 period. We used Cox regression analysis to calculate hazard ratios for mortality risks according to cumulative antipsychotic exposure levels (low, moderate, and high). Results: Our analyses revealed no significant association between antipsychotic exposure and mortality (either all-cause or cause-specific) in patients with schizophrenia. Conclusion Our results imply that the excess mortality of patients with schizophrenia is attributable to factors other than antipsychotic usage.

Background: The objective of this study was to investigate the trend of self-injurious behavior (SIB) among persons who were directly impacted by coronavirus disease 2019 (COVID-19), especially those with pre-existing mental disorders. Methods: Using the National Health Insurance Service-COVID-19 database cohort, the monthly SIB rate was calculated by COVID-19 subgroups (i.e., positive for COVID-19 test, negative for COVID-19 test, and non-COVID-19 test [control]). In addition, moderated regression analysis was utilized to examine the statistical difference of SIB (suicide attempt and non-suicidal self-injury using ICD-10 code) trend between COVID-19 subgroups and with and without pre-existing mental disorder. Results: A total of 328,373 persons were included in the cohort study. Of these, 212,678 had been tested for COVID-19, and 7,713 of them were confirmed positive. During the pandemic peak, the “negative for COVID-19” group showed a large increase (P = 0.003) in SIB rates compared to the control group, the “positive for COVID-19” group showed a decreasing trend, but not significant (P = 0.314). Among those who were tested for COVID-19, those with pre-existing mental disorders showed an increasing trend of SIB compared to those without pre-existing mental disorders, however statistically insignificant (P= 0.137). Conclusion Our results suggest that people who are tested for COVID-19 are at a high risk of SIB during the peak COVID-19 pandemic. Therefore, screening for suicide risk and psychological interventions is needed for these high-risk groups.

OBJECTIVES: The aim of this study was to analyze research and development projects in mental health services in Korea, using priority evaluation of mental health promotion policies to determine direction of the service. METHODS: An online survey was conducted that targeted experts in the mental health service regarding promotion of mental health in Korea in 2016. The survey was based on 32 policy projects that resulted from 12 strategies according to 4 policy objectives. RESULTS: Analysis of 32 mental health projects were assessed regarding the possibility of technology development success, magnitude of the ripple effect, and necessity of a national response. It was observed that 3 policy projects relevant to suicide, had a high relative priority. This was followed by policies for improvement of health insurance and the medical benefit cost system, and policies for reinforcement of crisis psychological support such as those for disaster victims. CONCLUSION: The prioritization of mental health services should place an emphasis on promotion of a healthy mental lifestyle, rehabilitation support for patients with serious mental illness, and reinforcement of social safety networks for suicide prevention.
Disaster Victims ; Health Promotion ; Humans ; Industrial Development ; Insurance, Health ; Korea ; Life Style ; Mental Health Services* ; Mental Health* ; Rehabilitation ; Social Change* ; Suicide