1.Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3
Seon-Cheol PARK ; Kiwon KIM ; Jeongsoo PARK ; Sun CHOI ; Seonhwa LEE ; Seungwon CHO ; Eunkyung KIM ; Tian-Mei SI ; Roy Abraham KALLIVAYALIL ; Andi J. TANRA ; Amir Hossein Jalali NADOUSHAN ; Kok Yoon CHEE ; Afzal JAVED ; Kang SIM ; Pornjira PARIWATCHARAKUL ; Takahiro A. KATO ; Shih-Ku LIN ; Naotaka SHINFUKU ; Norman SARTORIUS
Psychiatry Investigation 2025;22(5):552-563
Objective:
The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism.
Methods:
We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test.
Results:
Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness).
Conclusion
This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment.
2.Investigating Disembodiment-related Brain Activation by Interaction between Perspective-shifting and the Experience of Agency in Autism Spectrum Disorder: A Possible Relationship with Interoceptive Abilities
Ahjeong HUR ; Seungwon CHUNG ; Huiyeong JEON ; Hoyeon LEE ; Yong-Wook SHIN ; Jung-Woo SON
Clinical Psychopharmacology and Neuroscience 2025;23(1):86-99
Objective:
Many studies have explored sense of self in individuals with autism spectrum disorder (ASD); however, few have reported on their experience of “disembodiment.” This study aimed to investigate the differences in brain activity between patients with ASD and neurotypicals (NTs) under conditions causing disembodiment and to examine the correlation between their interoceptive abilities and disembodiment-related brain activity.
Methods:
18 Participants with ASD and 21 NTs completed psychological evaluations, interoceptive abilities measurement, and functional magnetic resonance imaging (fMRI). The fMRI images were taken while the participants performed tasks involving ball-throwing animations. The task focused on either self-agency related to ball-throwing (Agency Task) or the spatial location of a ball (Location Task). The animations were presented from constantly changing perspective (Changing View) or fixed perspective (Fixed View). The disembodiment-related condition was the interaction between the Agency Task and Changing View.
Results:
Participants with ASD exhibited higher activation than NTs in regions near the left parieto-temporo-occipital junction, left precuneus, left hippocampus, and other brain areas. Furthermore, interoceptive accuracy was negatively correlated with the activity of the left superior parietal and posterior midcingulate areas, whereas interoceptive trait prediction error was positively correlated with the activity of the left hippocampus, mid-temporal area, and left posterior cingulate area in participants with ASD.
Conclusion
These results suggest that disembodiment-related brain activation might be easily manifested by the interaction between perspective-shifting and the experience of agency, and that interoceptive abilities might be related to disembodiment-related brain activation in individuals with ASD.
3.Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3
Seon-Cheol PARK ; Kiwon KIM ; Jeongsoo PARK ; Sun CHOI ; Seonhwa LEE ; Seungwon CHO ; Eunkyung KIM ; Tian-Mei SI ; Roy Abraham KALLIVAYALIL ; Andi J. TANRA ; Amir Hossein Jalali NADOUSHAN ; Kok Yoon CHEE ; Afzal JAVED ; Kang SIM ; Pornjira PARIWATCHARAKUL ; Takahiro A. KATO ; Shih-Ku LIN ; Naotaka SHINFUKU ; Norman SARTORIUS
Psychiatry Investigation 2025;22(5):552-563
Objective:
The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism.
Methods:
We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test.
Results:
Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness).
Conclusion
This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment.
4.Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3
Seon-Cheol PARK ; Kiwon KIM ; Jeongsoo PARK ; Sun CHOI ; Seonhwa LEE ; Seungwon CHO ; Eunkyung KIM ; Tian-Mei SI ; Roy Abraham KALLIVAYALIL ; Andi J. TANRA ; Amir Hossein Jalali NADOUSHAN ; Kok Yoon CHEE ; Afzal JAVED ; Kang SIM ; Pornjira PARIWATCHARAKUL ; Takahiro A. KATO ; Shih-Ku LIN ; Naotaka SHINFUKU ; Norman SARTORIUS
Psychiatry Investigation 2025;22(5):552-563
Objective:
The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism.
Methods:
We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test.
Results:
Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness).
Conclusion
This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment.
5.Investigating Disembodiment-related Brain Activation by Interaction between Perspective-shifting and the Experience of Agency in Autism Spectrum Disorder: A Possible Relationship with Interoceptive Abilities
Ahjeong HUR ; Seungwon CHUNG ; Huiyeong JEON ; Hoyeon LEE ; Yong-Wook SHIN ; Jung-Woo SON
Clinical Psychopharmacology and Neuroscience 2025;23(1):86-99
Objective:
Many studies have explored sense of self in individuals with autism spectrum disorder (ASD); however, few have reported on their experience of “disembodiment.” This study aimed to investigate the differences in brain activity between patients with ASD and neurotypicals (NTs) under conditions causing disembodiment and to examine the correlation between their interoceptive abilities and disembodiment-related brain activity.
Methods:
18 Participants with ASD and 21 NTs completed psychological evaluations, interoceptive abilities measurement, and functional magnetic resonance imaging (fMRI). The fMRI images were taken while the participants performed tasks involving ball-throwing animations. The task focused on either self-agency related to ball-throwing (Agency Task) or the spatial location of a ball (Location Task). The animations were presented from constantly changing perspective (Changing View) or fixed perspective (Fixed View). The disembodiment-related condition was the interaction between the Agency Task and Changing View.
Results:
Participants with ASD exhibited higher activation than NTs in regions near the left parieto-temporo-occipital junction, left precuneus, left hippocampus, and other brain areas. Furthermore, interoceptive accuracy was negatively correlated with the activity of the left superior parietal and posterior midcingulate areas, whereas interoceptive trait prediction error was positively correlated with the activity of the left hippocampus, mid-temporal area, and left posterior cingulate area in participants with ASD.
Conclusion
These results suggest that disembodiment-related brain activation might be easily manifested by the interaction between perspective-shifting and the experience of agency, and that interoceptive abilities might be related to disembodiment-related brain activation in individuals with ASD.
6.Investigating Disembodiment-related Brain Activation by Interaction between Perspective-shifting and the Experience of Agency in Autism Spectrum Disorder: A Possible Relationship with Interoceptive Abilities
Ahjeong HUR ; Seungwon CHUNG ; Huiyeong JEON ; Hoyeon LEE ; Yong-Wook SHIN ; Jung-Woo SON
Clinical Psychopharmacology and Neuroscience 2025;23(1):86-99
Objective:
Many studies have explored sense of self in individuals with autism spectrum disorder (ASD); however, few have reported on their experience of “disembodiment.” This study aimed to investigate the differences in brain activity between patients with ASD and neurotypicals (NTs) under conditions causing disembodiment and to examine the correlation between their interoceptive abilities and disembodiment-related brain activity.
Methods:
18 Participants with ASD and 21 NTs completed psychological evaluations, interoceptive abilities measurement, and functional magnetic resonance imaging (fMRI). The fMRI images were taken while the participants performed tasks involving ball-throwing animations. The task focused on either self-agency related to ball-throwing (Agency Task) or the spatial location of a ball (Location Task). The animations were presented from constantly changing perspective (Changing View) or fixed perspective (Fixed View). The disembodiment-related condition was the interaction between the Agency Task and Changing View.
Results:
Participants with ASD exhibited higher activation than NTs in regions near the left parieto-temporo-occipital junction, left precuneus, left hippocampus, and other brain areas. Furthermore, interoceptive accuracy was negatively correlated with the activity of the left superior parietal and posterior midcingulate areas, whereas interoceptive trait prediction error was positively correlated with the activity of the left hippocampus, mid-temporal area, and left posterior cingulate area in participants with ASD.
Conclusion
These results suggest that disembodiment-related brain activation might be easily manifested by the interaction between perspective-shifting and the experience of agency, and that interoceptive abilities might be related to disembodiment-related brain activation in individuals with ASD.
7.Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3
Seon-Cheol PARK ; Kiwon KIM ; Jeongsoo PARK ; Sun CHOI ; Seonhwa LEE ; Seungwon CHO ; Eunkyung KIM ; Tian-Mei SI ; Roy Abraham KALLIVAYALIL ; Andi J. TANRA ; Amir Hossein Jalali NADOUSHAN ; Kok Yoon CHEE ; Afzal JAVED ; Kang SIM ; Pornjira PARIWATCHARAKUL ; Takahiro A. KATO ; Shih-Ku LIN ; Naotaka SHINFUKU ; Norman SARTORIUS
Psychiatry Investigation 2025;22(5):552-563
Objective:
The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism.
Methods:
We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test.
Results:
Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness).
Conclusion
This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment.
8.Investigating Disembodiment-related Brain Activation by Interaction between Perspective-shifting and the Experience of Agency in Autism Spectrum Disorder: A Possible Relationship with Interoceptive Abilities
Ahjeong HUR ; Seungwon CHUNG ; Huiyeong JEON ; Hoyeon LEE ; Yong-Wook SHIN ; Jung-Woo SON
Clinical Psychopharmacology and Neuroscience 2025;23(1):86-99
Objective:
Many studies have explored sense of self in individuals with autism spectrum disorder (ASD); however, few have reported on their experience of “disembodiment.” This study aimed to investigate the differences in brain activity between patients with ASD and neurotypicals (NTs) under conditions causing disembodiment and to examine the correlation between their interoceptive abilities and disembodiment-related brain activity.
Methods:
18 Participants with ASD and 21 NTs completed psychological evaluations, interoceptive abilities measurement, and functional magnetic resonance imaging (fMRI). The fMRI images were taken while the participants performed tasks involving ball-throwing animations. The task focused on either self-agency related to ball-throwing (Agency Task) or the spatial location of a ball (Location Task). The animations were presented from constantly changing perspective (Changing View) or fixed perspective (Fixed View). The disembodiment-related condition was the interaction between the Agency Task and Changing View.
Results:
Participants with ASD exhibited higher activation than NTs in regions near the left parieto-temporo-occipital junction, left precuneus, left hippocampus, and other brain areas. Furthermore, interoceptive accuracy was negatively correlated with the activity of the left superior parietal and posterior midcingulate areas, whereas interoceptive trait prediction error was positively correlated with the activity of the left hippocampus, mid-temporal area, and left posterior cingulate area in participants with ASD.
Conclusion
These results suggest that disembodiment-related brain activation might be easily manifested by the interaction between perspective-shifting and the experience of agency, and that interoceptive abilities might be related to disembodiment-related brain activation in individuals with ASD.
9.Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3
Seon-Cheol PARK ; Kiwon KIM ; Jeongsoo PARK ; Sun CHOI ; Seonhwa LEE ; Seungwon CHO ; Eunkyung KIM ; Tian-Mei SI ; Roy Abraham KALLIVAYALIL ; Andi J. TANRA ; Amir Hossein Jalali NADOUSHAN ; Kok Yoon CHEE ; Afzal JAVED ; Kang SIM ; Pornjira PARIWATCHARAKUL ; Takahiro A. KATO ; Shih-Ku LIN ; Naotaka SHINFUKU ; Norman SARTORIUS
Psychiatry Investigation 2025;22(5):552-563
Objective:
The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism.
Methods:
We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test.
Results:
Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness).
Conclusion
This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment.
10.Effectiveness Analysis of School-Based Self-Harm Prevention Program for Children and Adolescent Using Brief Dialectical Behavior Therapy Skills Training: Based on Age, Sex, Self-Harm History and Program Implementation Methods
Je Jung LEE ; Cheolgyu SHIN ; Hyunjeong KIM ; Sunkyu PARK ; Inyoung NOH ; Jonggook LEE ; Keun OH ; Heeyoung SEO ; Seungwon CHUNG
Korean Journal of Psychosomatic Medicine 2024;32(2):87-97
Objectives:
:This study aims to confirm the effectiveness of a school-based very-short-term dialectical be-havior therapy-skills training (DBT-ST) program for preventing self-harm among children and adolescents, considering factors such as age, sex, self-harm history, and methods of program implementation.
Methods:
:The study was conducted from September 2021 to December 2023, targeting 1,012 elementary and middle school students in the Chungcheong region. Changes in responses to the Depressed Mood Questionnaire(RDQ), the Difficulties in Emotion Regulation Scale-16 (DERS-16), ‘future self-harm possibility’ scores wereanalyzed and compared before and after the program, based on age, sex, self-harm history, and methods of program implementation.
Results:
:Overall, participants showed a decrease in the ‘rumination(RDQ) scale’ (t=10.49, p<0.001), ‘reversescored distraction (RDQ)’ (t=10.67, p<0.001) and the total DERS-16 (t=5.56, p<0.001) as well as a decrease in ‘future self-harm possibility’ score (t=4.26, p<0.001). Both elementary and middle school students showed decrease in ’rumination (RDQ)’ and distraction (RDQ), but only middle school students showed a decrease in theDERS-16 and most sub-scales. Regardless of sex, self-harm history, or methods of program implementation, adecrease in ’rumination (RDQ)’, distraction (RDQ) and the total DERS-16 scale and most sub-scales decreased.
Conclusions
:Our program appears to be effective as a primary prevention program for preventing self-harm among children and adolescents in a school setting.

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