Craving has been well known to be the most important clinical phenomenon in smoking cessation treatment and one that physicians always encounter. For successful and prolonged abstinence, understanding, evaluation, and management of craving are essential. The concept and definition of craving is still under debate, although its importance, relevance, and role in smoking relapse is evident. There are two types of craving, 'abstinence-induced craving' and 'cue-induced craving' according to time dynamic and causes. The evaluation of craving mainly depends on self-reported measures in the clinical field. Pharmacological treatments such as the nicotine patch, bupropion, and varenicline are effective for abstinence-induced craving. Psychosocial treatment and a few pharmacological agents such as nicotine gum and lozenges are useful for reducing cue-induced craving. This review was aimed at conveying up-to-date information on the characteristics, evaluation, and treatment of craving. Development of objective measurement tool for evaluation of craving is needed. The effects of pharmacological treatments on 'cue-induced craving' remain to be discovered. An active effort to alleviate each type of craving is necessary to enhance and prolong a patient's abstinence.
Benzazepines ; Bupropion ; Gingiva ; Nicotine ; Quinoxalines ; Recurrence ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Use Cessation Products ; Tobacco Use Disorder ; Varenicline

OBJECTIVE: To examine the reliability and validity of the self-report Korean version of Strengths and Difficulties Questionnaire (SDQ-Kr) in the community sample. METHODS: The SDQ-Kr was administered to a large sample of school children and adolescents (n=2814) and youth attendees of a psychiatric clinic (n=385) aged 11-16 years. To examine temporal stability, the same questionnaire was administered to a subsample of 167 school youths five to six weeks after the initial assessment. To examine the reliability, we calculated Cronbach's alpha coefficients for internal consistency and Pearson's correlations for test-retest stability. In order to evaluate the factorial structure of the SDQ-Kr items, we conducted an exploratory factor analysis (EFA) with varimax rotation. Finally, discriminant validity was examined by using receiver operating characteristic (ROC) curves employing the area under the curve (AUC) as an index of discriminant ability. RESULTS: Although the internal consistency of some subscales of the SDQ-Kr was somewhat less satisfactory (alpha coefficients; 0.28-0.54) than the English original, coefficients for the total difficulties scores approached sufficient levels (coefficients; 0.69). Other psychometric properties including discriminant validity (AUC for total difficulties and four subscales >0.7) were comparable to those obtained in other language studies. CONCLUSION: The self-report SDQ-Kr exhibited a low level of reliability, indicating that some items need to be further evaluated and revised to improve the psychometric properties. We suggest that the total difficulties score could be used with more confidence for screening possible mental health problems in youths.
Adolescent ; Child ; Humans ; Korea* ; Mass Screening ; Mental Health ; Psychometrics* ; Reproducibility of Results ; ROC Curve

OBJECTIVE: The aim of this study was to examine the mediating roles of uncontrolled eating and sedentary behaviours in the link of attention deficit hyperactivity disorder (ADHD) and weight. METHODS: A total of 352 children in fifth and sixth grade participated in the present study by completing the self-rated Three-Factor Eating Questionnaire and Children of Alcoholics Screening Test during regular classes. An additional questionnaire completed by their parents provided information about the children's ADHD and emotional symptoms, sedentary behaviour based on screen time, and parental variables. The questionnaires were surveyed within one week after their schools' annual physical check-up. RESULTS: Hierarchical regression analyses revealed that uncontrolled eating was complete mediator in association between ADHD symptoms and body mass index (BMI) for boys, incomplete mediator for girls. However, screen time had no significant effect on the ADHD symptoms-BMI link for both gender. CONCLUSION: The findings of this study suggest that gender specific intervention programs may be need to help eating behaviour in children with ADHD and overweight.
Alcoholics ; Attention Deficit Disorder with Hyperactivity* ; Body Mass Index ; Child ; Eating* ; Female ; Humans ; Mass Screening ; Negotiating ; Overweight ; Parents

Objectives: : The purpose of this study is to investigate depression and suicide ideation according to socioeconomic changes after COVID-19 among Korean adolescent. Methods: : Data on the study population were obtained from the 16th Korea Youth Risk Behavior Web-based Survey (KYRBS). The KYRBS is a nationally representative sample of Korean adolescents (aged 12-18 years) that originally included over 103 questions in 15 domains of health-risk behaviors. In the 16th KYRBS, a total 54,948 students from 793 schools responded to the survey. Chi-square test and logistic regression analysis were conducted regarding depression and suicide ideation. Results: : This study suggests that changes in the family household before and after COVID-19 pandemic are also affecting the mental health of the adolescents. The study shows that worse change of family household is significant associations with suicidal ideation and depression. Adolescents reporting worse (AOR 1.38; 95% CI 1.38-1.57) and much worse (AOR 2.07; 95% CI 1.87-2.29) were significantly more likely to report depression. Adolescents reporting worse (AOR 1.34; 95% CI 1.34-1.60) and much worse (AOR 2.01; 95% CI 1.76-2.29) were significantly more likely to report suicide ideation. Conclusions : In this study, it was confirmed that young people from socially disadvantaged backgrounds are at high risk of suicide ideation and more depression. The results of this study suggest that we should consider improving the screening and prevention of mental health problems for adolescents with poor socioeconomic changes of COVID-19.

OBJECTIVE: It has been well known that alcohol can modulate several ligand-gated ion channel and voltage-gated ion channels. But the roles of alcohol in the autonomic neurons still remain unclear. In this study, thus we characterized the neuronal acetylcholine receptor (nnAChRs) and investigated the modulation of nnAChRs by ethanol (EtOH). METHODS: We used whole-cells which were acutely dissociated male rat major pelvic ganglion (MPG) neurons, and used gramicidin perforated patch clamp techniques. RESULTS: MPG neurons can be classified on the basis of the response of the soma membrane to depolarizing current pulses ; either tonic or phasic neurons. Sympathetic neurons expressing T-type Ca(2+) channels showed tonic firing pattern, while parasympathetic neurons lacking T-type Ca(2+) channels phasic firing to depolarizing current pulses. When hyperpolarizing currents were injected, sympathetic neurons produced post-anodal rebound spikes, while parasympathetic neurons were silent. Under current clamp mode, Acetylcholine (ACh) evoked significant membrane depolarization and produced subsequently marked membrane hyperporization. Under whole-cell mode, application of ACh-induced inward currents held at holding potentials below 0 mV and reversal potential was close to 0 mV, an equilibrium potential of nonselective cation channel. The ACh-activated current was blocked by methyllycaconitine (MLA ; 10 micrometer), hexamethonium (100 micrometer) and alpha-bungarotoxin (alpha-BuTx ; 100 nM), nAChRs antagonists. EtOH (40 mM) potentiated ACh-induced depolarization and hyperpolarization. EtOH also increased both alpha-BuTx-sensitive and -insensitive ACh-activated currents. Futhermore, EtOH potentiated 5-HT-activated current but had a little effect on GABA-activated current. CONCLUSION: These results suggest that EtOH modulates nnAChRs and 5-HT receptors in MPG neurons.
Acetylcholine ; Animals ; Bungarotoxins ; Carisoprodol ; Ethanol ; Fires ; Ganglia, Autonomic ; Ganglion Cysts ; Gramicidin ; Hexamethonium ; Humans ; Ion Channels ; Male ; Membranes ; Neurons ; Patch-Clamp Techniques ; Rats ; Receptors, Nicotinic* ; Receptors, Serotonin

Objectives: ：This study looked at the effects of chronic IPV on suicide ideation among married women in the country. Methods: ：This study used data from the five-year-old Korea Welfare Panel and analyzed using questions about verbal and physical violence, depression and suicide ideation that were investigated every year. Age, education, and economic levels, drinking, religion, chronic disease, satisfaction with family relationship, satisfaction with social relationship, were included as variables. Results: ：The five-year cumulative score of verbal violence had a statistically significant effect on the depres-sive symptom, and the relative risk was 1.180. The relative risk of five-year-old cumulative score of verbal violence in suicidal ideation was 1.276, and it was also significant even if they exclude the effects of depressive symptom.On the other hand, the five-year cumulative score of physical violence was found to have no significant impact on suicide ideation if they excluded the effects of depressive symptom. Conclusions ：Unlike previous studies, this study found that chronic verbal IPVs increase suicide ideation,even though they do not contain effects of depression. Such findings suggest that intervention in IPV in married women may help reduce the nation's suicide rate.

Objectives: ：This study looked at the effects of chronic IPV on suicide ideation among married women in the country. Methods: ：This study used data from the five-year-old Korea Welfare Panel and analyzed using questions about verbal and physical violence, depression and suicide ideation that were investigated every year. Age, education, and economic levels, drinking, religion, chronic disease, satisfaction with family relationship, satisfaction with social relationship, were included as variables. Results: ：The five-year cumulative score of verbal violence had a statistically significant effect on the depres-sive symptom, and the relative risk was 1.180. The relative risk of five-year-old cumulative score of verbal violence in suicidal ideation was 1.276, and it was also significant even if they exclude the effects of depressive symptom.On the other hand, the five-year cumulative score of physical violence was found to have no significant impact on suicide ideation if they excluded the effects of depressive symptom. Conclusions ：Unlike previous studies, this study found that chronic verbal IPVs increase suicide ideation,even though they do not contain effects of depression. Such findings suggest that intervention in IPV in married women may help reduce the nation's suicide rate.

OBJECTIVES: To investigate clinical and symptomatic differences among motoric subtypes of delirium. METHODS: A total of 256 patients referred to psychiatric consultation services for delirium due to general medical condition were assessed retrospectively. Motoric subtypes were determined according to Lipowski's criteria for hyperactive, hypoactive and mixed subtypes. All patients were evaluated according to Delirium Rating Scale-Revised-98(DRS-98-R) by trained psychiatrists to obtain symptomatic profiles of delirium. RESULTS: Hyperactive subtype were 50.8%(n=130), mixed 46.1%(n=118) and hypoactive 3.1%(n=8). Hyperactive patients were younger than mixed subtype(69.62±13.976 vs. 73.97±11.569, p=0.022) and received antipsychotics to manage symptoms of delirium more frequently(83.8% vs. 57.6%, p<0.001). Hyperactive patients had higher DRS-R-98 scores on both noncognitive(7.14±3.543 for hyperactive, 5.62±3.279 for mixed subtype) and cognitive subscales(10.00±3.574 for hyperactive, 6.38±2.875 for hypoactive, 7.43±3.771 for mixed subtype, p<0.001). CONCLUSION: We demonstrated that clinical and symptomatic profiles were different across motoric subtypes in delirium. Diagnostic and therapeutic approach should be made differently according to motoric subtypes of delirium and special attention is needed not to underestimate or delay treatment in specific motoric subtype of delirium.
Antipsychotic Agents ; Delirium* ; Humans ; Psychiatry ; Retrospective Studies

OBJECTIVES: Delirium of hospitalized patients is common and it is significantly associated with increased mortality rate. Misdiagnosis rates of delirium are reported in a range of 36.7 to 63% in clinical setting. We aimed to identify the clinical features and symptomatic characteristics associated with misdiagnosis of delirium. METHODS: Subjects were 256 inpatients who were referred for psychiatric consultation and diagnosed with delirium by a psychiatrist at a university hospital between January 1 and June 30, 2012. Clinical data were obtained with retrospective chart review. Patients were divided into misdiagnosed group and correct diagnosed group, after reviewing the reason which were described in the consultation request form. RESULTS: Sixty nine(27%) subjects of the 256 patients were referred for other reasons(mood, substance, anxiety, dementia etc.) than "delirium/confusion" by clinician(misdiagnosed group). In misdiagnosed group, use of antipsychotics was more common. There were no differences between the two groups in age, gender, and department of referring clinician. Fluctuation score of DRS-R-98 was higher in the correct diagnosed group. CONCLUSIONS: In this study, the risk of misdiagnosis was higher when the patients have taken antipsychotics or less symptom fluctuation. Careful clinical attention is needed for diagnosis for delirium in these patients.
Antipsychotic Agents ; Anxiety ; Delirium* ; Dementia ; Diagnosis ; Diagnostic Errors ; Humans ; Inpatients ; Mortality ; Psychiatry ; Retrospective Studies

OBJECTIVES: The aim of this study was to clarify the role of alcohol use disorders and acute alcohol consumption in suicide attempts by gender. METHODS: Data of 1,152 suicide attempters(487 males and 742 females) who had visited an emergency center was gathered. Suicide attempts were categorized into three groups according to alcohol use: an alcohol use disorder group(AUD), an acute alcohol use group(AAU), and a no-alcohol use group(NAU). The intent and lethality of suicide attempts were evaluated by Suicidal Intents Scale and Risk-Rescue Rating Scale. RESULTS: For Suicidal Intents Scale score, the male AUD group revealed a significantly lower mean score than the male AAU one. However, there were no statistically significant differences for female subjects across subgroups. With regard to the Risk-Rescue Rating Scale score, there were no significant differences for males, while the AUD group showed both the lowest highest rescue scores and lowest risk-rescue scores within female groups. CONCLUSIONS: AUD in females was more likely regarding impulsive suicide attempts with high rescue chances. Consuming alcohol might have different effect on suicide attempts by gender and our study shows that alcohol use is an important risk factor according to gender, particularly with regard to female suicide attempts.
Alcohol Drinking ; Emergencies ; Female ; Humans ; Male ; Risk Factors ; Suicide