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.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.
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.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.
6.The Frontline of Clinical Acupuncture for Parkinson's Disease in Korean Medicine
Journal of the Japan Society of Acupuncture and Moxibustion 2024;74(3):147-155
Parkinson's disease (PD) is a neurodegenerative disease manifested by four major motor symptoms including resting tremor, rigidity, bradykinesia, and postural instability. Although pharmacotherapy is currently the gold standard, expectations are increasing worldwide for complementary and alternative therapies used to overcome the limitations of standard treatment in PD. The results of previous clinical trials indicate that acupuncture could help improve motor symptoms in patients with PD, especially in hypometric gait, which is a characteristic feature of PD. The mechanisms of effect are assumed to be reinforcement of neural plasticity, protective effects on dopaminergic neurons, normalization of neurochemical imbalances within the basal ganglia and functional connectivity of the brain, and reduction of gut microbiota dysbiosis. Further studies will be needed to confirm the specific clinical effects and to address the challenges of specifying the mechanisms.
7.Effect of different head positions on three-dimensional facial images
Jun-Hee YOON ; Do-Gil KIM ; Seungwon OH ; Jin-Hyoung CHO ; Min-Hee OH
Oral Biology Research 2024;48(1):7-14
The purpose of this study was to determine whether head posture affects three-dimensional (3D) facial images. This study evaluated facial images of 10 mannequins, which are taken from standard postures, left and right rotations, and up and down rotations. The images with changed head posture were superimposed onto standard head posture image, and the difference between the two images was used to evaluate deformations in images with the changed head postures. The 3D facial images showed considerable differences depending on different head positions.
8.Current status of occupational radiation exposure and protection among medical interns and residents
Seungwon CHO ; Hangyeol LEE ; Minku KANG ; Won Jin LEE ; Seulki KO
Journal of the Korean Medical Association 2024;67(2):134-146
Background:
While individuals exposed to radiation in hospitals are typically registered as radiation workers, with regulated exposure levels, many interns and residents who are not registered as radiation workers are occupationally exposed to radiation. This study aimed to assess the current status and awareness of radiation exposure and related protective practices among interns and residents.
Methods:
An online survey was conducted nationwide from June 3 to June 16, 2023, engaging 262 interns and 799 residents. Descriptive analyses were conducted to summarize the status of occupational radiation exposure and radiation protection practices.
Results:
Approximately 6% of interns and 18% of residents reported receiving personal dosimeters, and 6% and 20%, respectively, were registered as radiation workers. In contrast, compliance with personal radiation protection equipment, such as lead aprons and thyroid shields, exceeded 85% during tasks involving radiation exposure. On average, interns spent 7 months (standard deviation [SD], 2.1) and residents 8.1 months (SD, 4.8) in main departments with potential radiation exposure. While overall safety performance showed improvement, the provision of personal dosimeters and radiation worker registration remained low (14.7%, 16.6%).
Conclusion
Despite improvements in radiation protection education and the provision of personal protective equipment, the registration rate for radiation workers among interns and residents remains low. Ensuring these medical professionals are registered and managed as radiation workers is crucial for prioritizing their safety and well-being.
9.The Effect of Depressive Symptoms in Elderly on General and Cancer Health Screening Participation
Journal of Korean Geriatric Psychiatry 2023;27(1):8-15
Objective:
In this study, we investigate the effect of depressive symptoms in elderly on general and cancer health screening participation using the large epidemiological study data in South Korea.
Methods:
This study was conducted on 1,977 people who responded to a health examination questionnaire among 2,360 adults aged 60 or older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) in 2020.Depressive symptoms were measured by the Patient Health Questionnaire-9 and classified as minimal (0-4), mild (5-9), and moderate and severe (10-27). To investigate the relationship between depressive symptoms and health screening participation, a multiple logistic regression model controlling covariates was used.
Results:
Compared to the group with minimal depressive symptoms, the mild group did not show a significant difference (odd ratio [OR]=0.71, 95% confidence interval [95% CI]=0.45-1.13), but the moderate to severe group showed a significant negative relationship with general health screening participation (OR=0.59, 95% CI=0.35-0.99). There was a significant negative relation-ship between depressive symptoms and cancer health screening participation (mild group OR=0.77, 95% CI=0.48-1.23; moderate to severe group OR=0.50, 95% CI=0.28-0.87).
Conclusion
This study showed that people with depressive symptoms are less likely to get a general and cancer health screening. In order to promote health screening participation, policies that consider health behavior promotion programs and psychiatric interventions targeting moderate to severe depressive symptom groups are necessary.
10.Diagnostic Utility of Four Brief Korean Versions of the PTSD Checklist for DSM-5 in Adult Psychiatric Outpatient
Boyoung SON ; Daeho KIM ; Kyung Seu YOON ; Seungwon CHO
Mood and Emotion 2023;21(2):19-27
Background:
The post-traumatic stress disorder (PTSD) Checklist (PCL)-5, originally a 20-item self-questionnaire, has provided abbreviated versions of the checklist. This study aimed to test the diagnostic utility and validity of four brief versions of PCL-5 in a sample of adults seeking treatment at a psychiatric outpatient unit in a South Korean university-affiliated hospital.
Methods:
The sample comprised 97 adults diagnosed with PTSD and 130 diagnosed with other psychiatric disorders seeking treatment. Each abbreviated scale was examined with the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and positive predictive power. Additionally, internal consistency, correlation with full scale, convergent validity, and concurrent validity were investigated.
Results:
All four versions demonstrated excellent discriminative power, with AUC values of >0.9. Suggested cut-off scores were 6, 8, 11, and 16 for the short four-item version (S4), PCL4, PCL6, and PCL8, respectively. Internal consistency was adequate or good except for S4. Additionally, brief scales demonstrated good convergent validity with depression and anxiety scales and excellent concurrent validity with other PTSD scales.
Conclusion
This study confirms the excellent diagnostic utility and adequate validity of four abbreviated versions of the Korean translation of PCL-5 in the clinical trial.


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