OBJECTIVES: Dissociative Experiences Scale (DES) is the most widely used and studied instrument for measuring dissociative symptoms with its favorable psychometric properties well described in the literature. However, recent debate on factor structure and multidimensionality has brought attention to factorial validity of the scale. This study tested the factor structure of a Korean translation of the scale (KDES-II) with confirmatory factor analysis in a clinical population. METHODS: Exploratory principal component analysis were conducted with data from 340 psychiatric patients and confirmatory factor analysis (maximum likelihood estimation) with 262 psychiatric outpatients. RESULTS: Exploratory analysis revealed four factor structure of the scale with total variance of 55.9% : Depersonalization/derealization (Factor 1), Amnestic dissociation (Factor 2), Absorption (Factor 3), and Pseudopsychotic symptoms (Factor 4). However, original three- and one- factor model were also acceptable considering the goodness-of-fit indices. CONCLUSION: Despite heterogeneity of the sample, KDES-II showed factorial validity and supported a cross cultural stability of DES. We suggest use of original three factor solution for Korean clinical population.
Absorption ; Factor Analysis, Statistical ; Humans ; Outpatients ; Population Characteristics ; Principal Component Analysis ; Psychometrics

OBJECTIVES: The objectives of this study are to assess marital and sexual satisfaction among patients with schizophrenia compared to the general population and to evaluate the factors that may affect these levels. METHODS: Marital and sexual satisfaction of 66 married schizophrenic patients and 162 married normal controls were assessed with Enriching and Nurturing Relationship Issues, Communication and Happiness and Derogatis Sexual Function Inventory. We compared the differences in marital and sexual satisfaction and influential variables between these two groups through analysis of covariance with adjustment for age and the duration of marriage. Factors associated with marital and sexual satisfaction were identified with multiple regression analysis. RESULTS: Patients with schizophrenia showed lower satisfaction with their marriage (p=0.018) and sexual lives (p<0.001) compared to the controls. Marital satisfaction of schizophrenics was influenced by violence from spouse, whereas their sexual satisfaction was affected by age, violence from spouse, conversation frequency after sexual relations, and revealing psychiatric history to spouse before marriage. There was a significant relationship between marital and sexual satisfaction in both groups. CONCLUSION: Patients with schizophrenia may have marital and sexual problems which can be caused directly or indirectly by symptoms and course of the disease. These results suggest that evaluation and appropriate intervention in the marriage and sexual lives of schizophrenics is necessary and important.
Happiness ; Humans ; Marriage ; Schizophrenia ; Spouses ; Violence

This review aimed to assist clinicians in the identification and assessment of adult attention-deficit hyperactivity disorder (ADHD) with an emphasis on diagnostic and rating instruments. Pubmed and RISS were utilized to identify relevant studies and critical reviews on the diagnosis and assessment of adult ADHD, published between 1988 and 2010. The Adult ADHD Self-Report Scale-v1.1, the ADHD Rating Scale-IV, the Conners Adult ADHD Rating Scale, and the Current Symptoms Scale have been utilized for self-reporting of current ADHD symptoms. The Brown ADD Rating Scale, the ADHD Rating Scale-IV, the Current Symptoms Scale, and the Conners Adult ADHD Rating Scale have also been evaluated by an observer. The Childhood Symptom Scale and the Wender-Utah Rating Scale have been used for retrospective assessment of childhood ADHD symptoms and the Adult ADHD Investigator Symptom Rating Scale, the Adult Interview, the Brown ADD Diagnostic Form, the Conners adult ADHD diagnostic interview for DSM-IV, and the Wender-Reimherr Interview have been available as comprehensive diagnostic interviews. There is a wide variety of instruments available with respect to adult ADHD. The choice of appropriate instruments is essential for achieving accurate diagnosis and assessment of this disorder.
Adult ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Research Personnel ; Retrospective Studies ; Weights and Measures

One author's affiliation is misspelled in original article.

Smokers keep smoking despite knowing that tobacco claims many lives, including their own and others’. What makes it hard for them to quit smoking nonetheless? Tobacco companies insist that smokers choose to smoke, according to their right to self-determination. Moreover, they insist that with motivation and willpower to quit smoking, smokers can easily stop smoking. Against this backdrop, this paper aims to discuss the addictive disease called tobacco use disorder, with an assessment of the addictiveness of tobacco and the reasons why smoking cessation is challenging, based on neuroscientific research. Nicotine that enters the body via smoking is rapidly transmitted to the central nervous system and causes various effects, including an arousal response. The changes in the nicotine receptors in the brain due to continuous smoking lead to addiction symptoms such as tolerance, craving, and withdrawal. Compared with other addictive substances, including alcohol and opioids, tobacco is more likely to cause dependence in smokers, and smokers are less likely to recover from their dependence. Moreover, the thinning of the cerebral cortex and the decrease in cognitive functions that occur with aging accelerate with smoking. Such changes occur in the structure and functions of the brain in proportion to the amount and period of smoking. In particular, abnormalities in the neural circuits that control cognition and decision-making cause loss of the ability to exert self-control and autonomy. This initiates nicotine dependence and the continuation of addictive behaviors. Therefore, smoking is considered to be a behavior that is repeated due to dependence on an addictive substance, nicotine, instead of one’s choice by free will.
Aging ; Analgesics, Opioid ; Arousal ; Behavior, Addictive ; Brain ; Central Nervous System ; Cerebral Cortex ; Cognition ; Craving ; Jurisprudence ; Motivation ; Nicotine ; Personal Autonomy ; Self-Control ; Smoke ; Smoking Cessation ; Smoking ; Tobacco Use Disorder ; Tobacco

Depression is one of the most common mental disorders. Some characteristics of depression in Korea were elucidated. The tendency to express depressive feeling through somatic complaints is more prominent in Korea than in Western countries. Careful studies on depressive symptoms suggest that guilt and suicidal idea are apparent among Korean depressive patients as well as among Western subjects. But most depressive patients in Korea are reluctant to express suicidal idea, which is hidden under the somatic complaints. We should remember the possibility of research artifacts or cultural bias with regard to the evaluation of depressive symptoms of a country in comparison with other countries. Non-pharmacological treatment of depression includes dynamic psychotherapy, cognitive behavioral therapy, interpersonal psychotherapy, self-care treatment, etc. Some kinds of Korean culture relevant psychotherapies are introduced: Tea therapy, Imago therapy, Tao psychotherapy, and combined approach. Interest in the aged people is growing recently, and the research about the factors which affect the depressive disorders in older patients and treatment strategy for them is ongoing.
Artifacts ; Bias (Epidemiology) ; Cognitive Therapy ; Depression* ; Depressive Disorder ; Guilt ; Humans ; Korea* ; Mental Disorders ; Psychotherapy ; Self Care ; Tea ; Troleandomycin

Rheumatoid arthritis (RA) is a chronic inflammatory disease of multifactorial etiology. Smoking is considered one of the most established environmental risk factors for RA development and severity. A large proportion of patients with RA have a high prevalence of smoking history. Previous studies have provided evidence suggesting that smoking is associated with the development of RA. Smoking has been associated with several pathogenic mechanisms on RA development such as oxidative stress, inflammation, and epigenetic changes. There is a need for public health campaigns to educate the public regarding these risks and preventive measures that reduce smoking are essential and may result in a decline in RA incidence. Encouragement of smoking cessation is especially warranted in relatives of patients with RA. Recently, RA-specific smoking cessation interventions have been developed. This review will summarize the knowledge accumulated to date concerning associations between smoking and RA.
Arthritis, Rheumatoid* ; Epigenomics ; Humans ; Incidence ; Inflammation ; Nicotine ; Oxidative Stress ; Prevalence ; Public Health ; Risk Factors* ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco

Smokers keep smoking despite knowing that tobacco claims many lives, including their own and others’. What makes it hard for them to quit smoking nonetheless? Tobacco companies insist that smokers choose to smoke, according to their right to self-determination. Moreover, they insist that with motivation and willpower to quit smoking, smokers can easily stop smoking. Against this backdrop, this paper aims to discuss the addictive disease called tobacco use disorder, with an assessment of the addictiveness of tobacco and the reasons why smoking cessation is challenging, based on neuroscientific research. Nicotine that enters the body via smoking is rapidly transmitted to the central nervous system and causes various effects, including an arousal response. The changes in the nicotine receptors in the brain due to continuous smoking lead to addiction symptoms such as tolerance, craving, and withdrawal. Compared with other addictive substances, including alcohol and opioids, tobacco is more likely to cause dependence in smokers, and smokers are less likely to recover from their dependence. Moreover, the thinning of the cerebral cortex and the decrease in cognitive functions that occur with aging accelerate with smoking. Such changes occur in the structure and functions of the brain in proportion to the amount and period of smoking. In particular, abnormalities in the neural circuits that control cognition and decision-making cause loss of the ability to exert self-control and autonomy. This initiates nicotine dependence and the continuation of addictive behaviors. Therefore, smoking is considered to be a behavior that is repeated due to dependence on an addictive substance, nicotine, instead of one’s choice by free will.

OBJECT: To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. METHODS: This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. RESULTS: We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. CONCLUSION: Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.
Antipsychotic Agents ; Follow-Up Studies ; Humans ; Inpatients ; Male ; Outpatients ; Rehabilitation ; Retrospective Studies ; Schizophrenia*

Background: The rate of suicide by carbon monoxide (CO) poisoning is increasing rapidly in Korea. In this study, we aimed to investigate the clinical characteristics of suicide attempters in Korea and to identify risk groups for choosing CO poisoning as a suicide method. Methods: Patients who visited the emergency department after attempting suicide between April 2017 and June 2019 were included in this study. We reviewed the medical records and evaluated the demographic and clinical data of suicide attempters. Cross-tabulation analyses and multivariable logistic regression analyses were performed. Results: Statistically significant risk groups for suicide by CO poisoning were men (odds ratios [OR], 1.71), those who were 25-44 years of age (OR, 7.35), those with no psychiatric history (OR, 2.12), and those who made a suicide plan (OR, 7.70). Among suicide attempters grouped according to psychiatric diagnoses, those with adjustment disorders were most likely and those with psychosis were least likely to choose CO poisoning as the suicide method. Conclusion To prevent a CO poisoning suicide attempt, it seems warranted to develop a tool to screen patients for suicide risk as part of a regular health checkup so that early intervention can be provided.