No abstract available.
Child* ; Goiter* ; Humans

Objective: To prevent the spread of infection in Korea during the corona virus disease 2019 (COVID-19) outbreak, real-time warnings have been sent to all residents via mobile phones. This study examined the factors associated with the negative emotional response to media news and emergency text alerts in the COVID-19 pandemic. Methods: A survey was completed by 1,500 adults from an online public panel in three regions. We used Patient Health Questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Perceived Stress Scale-10 (PSS-10) to assess the level of depression, anxiety and stress, respectively. Questionnaires related to COVID-19 included fear of infection, and fear of disclose of contact-tracing information. Results: The negative emotional response on both news media information and emergency alert text messages about COVID-19 was associated with fear of COVID-19 infection and high anxiety. The biggest outbreak city, Daegu was associated with the less negative emotional response on emergency alert text messages. Fear of disclose of contact-tracing information was significantly associated with negative emotional perception on emergency alter text messages. Conclusion Our results suggest that effective information providing services with considering vulnerable groups are needed to promote acceptance and eliminate negative emotion for disease related information.

Objective: To prevent the spread of infection in Korea during the corona virus disease 2019 (COVID-19) outbreak, real-time warnings have been sent to all residents via mobile phones. This study examined the factors associated with the negative emotional response to media news and emergency text alerts in the COVID-19 pandemic. Methods: A survey was completed by 1,500 adults from an online public panel in three regions. We used Patient Health Questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Perceived Stress Scale-10 (PSS-10) to assess the level of depression, anxiety and stress, respectively. Questionnaires related to COVID-19 included fear of infection, and fear of disclose of contact-tracing information. Results: The negative emotional response on both news media information and emergency alert text messages about COVID-19 was associated with fear of COVID-19 infection and high anxiety. The biggest outbreak city, Daegu was associated with the less negative emotional response on emergency alert text messages. Fear of disclose of contact-tracing information was significantly associated with negative emotional perception on emergency alter text messages. Conclusion Our results suggest that effective information providing services with considering vulnerable groups are needed to promote acceptance and eliminate negative emotion for disease related information.

Biomarkers of suicidal behavior (SB), particularly peripheral biomarkers, may aid in the development of preventive and intervention strategies. The peripheral biomarkers of SB should be easily accessible, cost-effective, and minimally invasive. To identify peripheral biomarkers of SB, we summarized the current knowledge related to SB biomarkers with a focus on suicidal outcomes (suicidal ideation [SI], suicide risk [SR], suicide attempt [SA], and suicide death [SD]), measured site (center or periphery), and study design (cross-sectional or longitudinal). We also evaluated the central findings to validate the findings of peripheral biomarkers of SB. We found reduced peripheral interleukin (IL)-2 levels in individuals with a recent SA, higher cerebrospinal fluid (CSF) IL-6 levels in patients with a current SR and future SD, higher CSF tumor necrosis factor-α levels for current and future SRs, higher high-sensitivity C-reactive protein levels and lower peripheral total cholesterol levels for recent SAs, lower peripheral 5-HT levels for present SR, and a lower folate level for future SR and SA within 1 year. Previous studies have shown inconsistent associations of low peripheral leptin levels with SR and recent SA; therefore, further study is required. Given the multiple determinants of SB and weak associations with single biological markers, combinations of potential biological markers rather than single markers may improve the screening, diagnosis, and prediction of SB.

Exposure-response prevention is an effective approach to treat anxiety disorders. Virtual reality exposure therapy (VRET) is a promising treatment for patients with posttraumatic stress disorder (PTSD). New research has helped refine and update VRET. In this study, we introduce a form of VRET developed for patients suffering from PTSD after a traffic accident, and present two cases treated using this protocol. After 6 weeks of VRET treatment, the two participants not only improved their PTSD symptoms, but also improved their depressed mood, anxiety, and insomnia symptoms. Future studies of VRET for car accident-related PTSD should utilize a controlled design with randomization in order to account for numerous possible confounds.

Objective: Sudden traumatic physical injuries often cause psychological distress, which may be associated with chronic disability. Although considerable effort has been expended to identify genetic predictors of post-traumatic stress disorder (PTSD) after traumatic events, genetic predictors of psychological distress in response to severe physical injuries have been yet to be elucidated using whole exome sequencing (WES). Here, the genetic architecture of post-traumatic syndrome (PTS), which encompasses a broad range of psychiatric disorders after traumatic events including depression, anxiety disorder, acute stress disorder, and PTSD, was explored using WES in severely physically injured patients, focusing on secondary findings and potential PTS-related variants. Methods: In total, 141 severely physically injured patients were consecutively recruited, and PTS was evaluated within 1 month of the injury. Secondary findings were analyzed according to PTS status. To identify PTS-related variants, genome-wide association analyses and the optimal sequencing kernel association test were performed. Results: Of the 141 patients, 88 (62%) experienced PTS. There were 108 disease-causing variants in severely physically injured patients. As secondary findings, the stress- and inflammation-related signaling pathways were enriched in the PTS patients, while the glucose metabolism pathway was enriched in those without PTS. However, no significant PTS-related variants were identified. Conclusion Our findings suggest that genetic alterations in stress and inflammatory pathways might increase the likelihood of PTS immediately after severe physical injury. Future studies with larger samples and longitudinal designs are needed.

OBJECTIVES: This study examined the factors associated with suicidal behavior in psychiatric inpatients. METHODS: The medical records of 208 psychiatric inpatients were reviewed retrospectively. The factors related to suicide attempts and ideation at the time of admission, and during outpatient follow-up, were investigated. RESULTS: In total, 120 patients (57.7%) with a history of at least one suicide attempt, and 163 patients (78.4%) who reported active suicide ideation (e.g., a suicide plan or intention to commit suicide) at the time of admission were reviewed. Being unmarried or divorced, substance abuse, impulsivity, and a poor social support system were associated with a history of suicide attempts. The suicidal ideation group had significantly higher rates of coexisting depression, severe depressive symptoms, hopelessness, and impulsivity, as well as a lower incidence of moral objection to suicide and high religiosity. In total, 15 out of 193 patients (7.8%) who were followed-up at outpatient clinics attempted suicide after discharge. Patients who attempted suicide or reported suicidal ideation at the outpatient clinic after discharge were significantly more likely to have a history of previous suicide attempts, or have had active suicide ideation at the time of admission. Good social support and high responsibility to family were inversely associated with suicidal ideation as an outpatient. CONCLUSION: A history of suicide attempts and ideation at the time of hospital admission were the risk factors for future outpatient suicidal behavior. Further study is warranted to develop a checklist and assessment measures of the various risk and protective factors associated with suicidal behavior.
Ambulatory Care Facilities ; Checklist ; Depression ; Divorce ; Follow-Up Studies ; Humans ; Impulsive Behavior ; Incidence ; Inpatients ; Intention ; Medical Records ; Outpatients ; Protective Factors ; Retrospective Studies ; Risk Factors ; Single Person ; Substance-Related Disorders ; Suicidal Ideation ; Suicide ; Suicide, Attempted

Objective: The aim of the study was to develop a checklist for mental health clinicians to predict and manage suicidality. Methods: A literature review of the risk and protective factors for suicide was conducted to develop a checklist for evaluating suicidality. Results: The fixed risk factors included sex (male), age (older individuals), history of childhood adversity, and a family history of suicide. Changeable risk factors included marital status (single), economic status (poverty), physical illness, history of psychiatric hospitalization, and history of suicide attempts. Recent discharge from a mental hospital and a recent history of suicide attempts were also included. Manageable risk factors included depression (history and current), alcohol problems (frequent drinking and alcohol abuse), hopelessness, agitation, impulsivity, impaired reality testing, and command hallucinations. Protective factors included responsibility to family, social support, moral objections to suicide, religiosity, motivation to get treatment, ability to cope with stress, and a healthy lifestyle. A final score was assigned based on the sum of the risk and protective factor scores. Conclusion We believe that the development of this checklist will help mental health clinicians to better assess those at risk for suicidal behavior. Further studies are necessary to validate the checklist.

Objective: This study investigated associations of life stressors and serum ghrelin levels with suicidal ideation (SI), and evaluated the potential mediating effect of ghrelin on associations between life stressors and SI in patients with acute coronary syndrome (ACS). Methods: In total, 969 ACS patients recruited from a tertiary university hospital in Korea within 2 weeks of disease onset were evaluated in terms of life stressors (using the List of Threatening Events Questionnaire), serum ghrelin levels, and SI (using the “suicidal thoughts” item of the Montgomery–Asberg Depression Rating Scale). Covariates included sociodemographics, depression, vascular risk factors, and disease severity. After 1 year, 711 patients were re-evaluated in terms of SI; logistic regression was performed with adjustment for covariates. Results: Life stressors were significantly associated with SI at baseline and follow-up. Serum ghrelin showed no such associations, but high levels thereof mediated associations of life stressors with SI; significant interaction terms were also observed after adjustment for covariates. Conclusion By evaluating life stressors and serum ghrelin levels, clinical prediction of SI in the acute and chronic phases of ACS could be improved.