OBJECTIVES: Adolescent depression is a complex disorder influenced by a variety of personal and familial factors. In this study, we compared the familial, cognitive, and behavioral characteristics of adolescents with and without diagnosed depression. METHODS: Forty adolescents with depressive disorder were recruited from two psychiatric clinics, along with 46 healthy adolescents from a middle school and a high school. We then compared the participants' cognitive and behavioral characteristics and the child-rearing attitudes of their parents. RESULTS: Compared to the healthy adolescents, the adolescents with depression exhibited lower self-esteem, higher emotional reappraisal, greater disruptive behavior, and lower attention. Furthermore, compared to the mothers of the healthy adolescents, the mothers of those with depression reported less affective, less autonomic, and more rejecting parenting attitudes towards their children. CONCLUSION: We found that attentional problems, negative parenting attitudes, negative self-cognition, and expressive suppression are all associated with adolescent depression. Parenting education and interventions appear to be needed to correct the negative cognitions of adolescents with depression.
Adolescent* ; Child ; Cognition ; Depression* ; Depressive Disorder ; Education, Nonprofessional ; Humans ; Mothers ; Parenting ; Parents ; Problem Behavior

The association of sexual victimization with self-esteem, depression, and problematic internet use was examined in Korean adolescents. A total of 695 middle and high school students were recruited (413 boys, 282 girls, mean age, 14.06±1.37 years). The participants were administered the Early Trauma Inventory Self Report-Short Form (ETISR-SF), Rosenberg's Self-Esteem Scale (RSES), the Children's Depression Inventory (CDI), and Young's Internet Addiction Test (IAT). The associations between sexual abuse and the level of self-esteem, depressive symptoms, and problematic internet use were analyzed. Adolescents who had experienced sexual abuse showed lower self-esteem, more depressive symptoms, and greater problematic internet use compared with adolescents who had not experienced sexual abuse. In the path model, sexual abuse predicted lower self-esteem (β=−0.11; 95% CI=−0.20, −0.04; p=0.009), which predicted higher depressive symptoms (β=−0.34; 95% CI=−0.40, −0.27; p=0.008). Depressive symptoms predicted problematic internet use in a positive way (β=0.23; 95% CI=0.16–0.29; p=0.013). Sexual abuse also predicted problematic internet use directly (β=0.20; 95% CI=0.12–0.27; p=0.012). The results of the present study indicate that sexually abused adolescents had a higher risk of depression and problematic internet use. For sexually abused adolescents, programs aimed at raising self-esteem and preventing internet addiction, as well as mental health screening, are needed.
Adolescent* ; Crime Victims ; Depression* ; Female ; Humans ; Internet* ; Mass Screening ; Mental Health ; Sex Offenses*

Objectives: ：Depression and stress-related response is common symptoms in mental health outpatients. The purpose of this study was to investigate the differences of change in heart rate variability parameters between patients with depressive disorder and those with trauma and stressor related disorders. Methods: ：We conducted a retrospective chart review of outpatients from 2014 to 2020 in Anxiety and Stress Outpatients Clinic of National Center for Mental Health. A total of 381 patients with depressive disorder and trauma and stressor related disorders were selected as dataset. Each parameter of 5-min analysis of Heart Rate Variability from the first and second visit was analyzed according to diagnosis. Results: ：At the first visit, root mean square of the differences of successive normal to normal intervals indicators showed significant differences between depressive disorder, and trauma and stressor related disorders. The change of Heart Rate Variability indicators for each group showed the following results: Significant differences between the first and second visit were found in standard deviation of normal to normal intervals, root mean square of the differences of successive normal to normal intervals, and low frequency among patients with the depressive disorder. Patients with trauma and stressor related disorders showed significant differences in root mean square of the differences of successive normal to normal intervals, high frequency between each visit. Conclusions ：Our results suggest the changes in Heart Rate Variability parameters between first visit and second visit in both depressive disorders and trauma and stressor related disorders. However, further research should examine factors that influence the differential changes of Heart Rate Variability parameters.

OBJECTIVE: This study aimed to examine the associations between depression and both coronary artery disease (CAD) and cardiovascular risk factors (CVRs) in Korean women. Furthermore, this study sought to determine whether depression was associated with use of healthcare services in women with CAD or CVRs. METHODS: This cross-sectional study was conducted on 26,335 women who were aged 19 years or older, and who participated in the Korean National Health and Nutrition Examination Survey (2007–2014). Associations of prior diagnosis of depression with CAD and CVRs and with nonutilization of healthcare services were investigated. RESULTS: Women with depression had a higher prevalence of CAD and CVRs including obesity, hypertension, dyslipidemia, and metabolic syndrome than those without depression. In addition, depression was significantly associated with nonutilization of healthcare services in women with most CVRs. CONCLUSION: Considering the high rate of comorbid depression with CAD or CVRs and the low lvels of health service utilization in depressed patients, screening for common CVRs, such as obesity, hypertension, and dyslipidemia, should be provided for patients with depression in mental health care settings.
Coronary Artery Disease ; Cross-Sectional Studies ; Delivery of Health Care* ; Depression* ; Diagnosis ; Dyslipidemias ; Female ; Health Services ; Humans ; Hypertension ; Mass Screening ; Mental Health ; Nutrition Surveys ; Obesity ; Prevalence ; Risk Factors

OBJECTIVE: We aimed to examine the rates, correlates, methods, and precipitating factors of suicide attempts among adolescent patients admitted for psychiatric inpatient care from 1999 to 2010 in a university hospital in Korea. METHODS: The subjects consisted of 728 patients who were admitted for psychiatric inpatient care in a university hospital over a 12-year period and who were aged 10-19 years at the time of admission. We retrospectively investigated the information on suicidal behaviors and other clinical information by reviewing the subjects' electronic medical records. Whether these patients had completed their suicide on 31 December 2010 was determined by a link to the database of the National Statistical Office. RESULTS: Among 728 subjects, 21.7% had suicidal ideation at admission, and 10.7% admitted for suicidal attempts. Female gender, divorced/widowed parents, and the presence of mood disorders were associated with a significantly increased likelihood of suicide attempts. Most common method of suicide attempts was cutting, and most common reason for suicide attempts was relationship problems within the primary support group. A diagnosis of schizophrenia was associated with increased risk of death by suicide after discharge. CONCLUSION: These results highlight the role of specific psychosocial factor (e.g., relational problems) and psychiatric disorders (e.g., mood disorders) in the suicide attempts of Korean adolescents, and the need for effective prevention strategies for adolescents at risk for suicide.
Adolescent* ; Diagnosis ; Electronic Health Records ; Female ; Humans ; Inpatients* ; Korea ; Mood Disorders ; Parents ; Precipitating Factors* ; Psychology ; Retrospective Studies ; Risk Factors ; Schizophrenia ; Self-Help Groups ; Suicidal Ideation ; Suicide*

OBJECTIVE: This study examined the association between the sleep patterns and depression of middle school students in Seoul. METHODS: 450 adolescents attending middle school (mean age 14.07 years, 40% male) responded to the survey. The participants answered the self-administered questionnaires about sleep patterns (Morningness-Eveningness Questionnaire, MEQ), sleep problems (Insomnia Severity Index, ISI ; Epworth Sleepiness Scale, ESS), and depressive symptoms (Children's Depression Inventory, CDI). RESULTS: The depressive group represented 25.9% of the total study sample with females exhibiting higher depressive index scores than males. Although the difference in the total sleeping time between the depressive group and control group was unspecified, the ISI and ESS scores were significantly higher in the depressive group than in the control group. In addition, there was a significant positive correlation between the total ISI and CDI scores. Those who scored higher than 8 on the ISI were 2.24 times more likely to belong to the depressive group, and those who scored higher than 7 on the ESS were 2.23 times more likely to belong to the depressive group. CONCLUSION: The depressive group tended to suffer from insomnia and experience more severe daytime sleepiness than students in the control group. In addition, students suffering from more severe insomnia tended to have higher CDI scores than their counterparts. Furthermore, students suffering from insomnia and/or experiencing daytime sleepiness were at least twice as likely to develop depression than other students.
Adolescent ; Depression* ; Female ; Humans ; Male ; Seoul* ; Sleep Initiation and Maintenance Disorders

The emergence of a new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has become a significant health concern worldwide. Undoubtedly, a better understanding of the innate and adaptive immune responses against SARS-CoV-2 and its relationship with the coronavirus disease 2019 (COVID-19) pathogenesis will be the sole basis for developing and applying therapeutics. This review will summarize the published results that relate to innate immune responses against infections with human coronaviruses including SARS-CoV-1 and SARS-CoV-2 in both humans and animal models. The topics encompass the innate immune sensing of the virus to the dysregulation of various innate immune cells during infection and disease progression.

Objectives: There is an increasing number of North Korean adolescents in South Korea. These adolescents need clinical attention as they experience a high risk of suicidal behavior because of the childhood adversity and acculturative challenges that they face before and after arriving in South Korea. This study assessed the risk of suicide attempts among North Korean adolescents compared to South Korean adolescents, and investigated the contributing factors for each group. Methods: We used data from the Korean Youth Risk Behavior Web-Based Survey (KYRBS) spanning 2011 to 2018, in which 404 adolescents had a father and/or mother who was a North Korean native. Data on 1,212 propensity-matched South Korean adolescents were extracted from the 2011 to 2018 KYRBS. Prevalence was calculated and compared by group. Separate odds ratios were calculated by group. Results: The North Korean group had a significantly higher suicide attempt rate [unadjusted odds ratio (OR)=8.27; adjusted OR=8.45].Multivariate analysis indicated that having a low or high socioeconomic status and depressive symptoms were significantly associated with suicide attempts in North Korean adolescents, while being female, having a high socioeconomic status, alcohol use, and depressive symptoms were significantly related to suicide attempts in South Korean adolescents. Conclusion The results found similarities and differences in the factors associated with the likelihood of suicide attempts in the two groups. From these results, different approaches are needed when planning interventions for each group.

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.

Objectives: There is an increasing number of North Korean adolescents in South Korea. These adolescents need clinical attention as they experience a high risk of suicidal behavior because of the childhood adversity and acculturative challenges that they face before and after arriving in South Korea. This study assessed the risk of suicide attempts among North Korean adolescents compared to South Korean adolescents, and investigated the contributing factors for each group. Methods: We used data from the Korean Youth Risk Behavior Web-Based Survey (KYRBS) spanning 2011 to 2018, in which 404 adolescents had a father and/or mother who was a North Korean native. Data on 1,212 propensity-matched South Korean adolescents were extracted from the 2011 to 2018 KYRBS. Prevalence was calculated and compared by group. Separate odds ratios were calculated by group. Results: The North Korean group had a significantly higher suicide attempt rate [unadjusted odds ratio (OR)=8.27; adjusted OR=8.45].Multivariate analysis indicated that having a low or high socioeconomic status and depressive symptoms were significantly associated with suicide attempts in North Korean adolescents, while being female, having a high socioeconomic status, alcohol use, and depressive symptoms were significantly related to suicide attempts in South Korean adolescents. Conclusion The results found similarities and differences in the factors associated with the likelihood of suicide attempts in the two groups. From these results, different approaches are needed when planning interventions for each group.