BACKGROUND AND OBJECTIVES: Although new technology of assistive listening device leads many hard of hearing children to be mainstreamed in public school programs, many clinicians and teachers still wonder whether the children are able to understand all instruction, access educational materials, and have social skills in the school. The purpose of this study is to develop a school adaptation program (SAP) for the hearing-impaired children who attend public elementary school. SUBJECTS AND METHODS: The theoretical framework of the SAP was a system model including microsystem, mesosystem, and macrosystem merged with Keller's ARCS theory. RESULTS: The SAP consisted of 10 sessions based on five categories (i.e., school life, activity in the class, relationship with friends, relationship with teacher, and school environments). For preliminary validity testing, the developed SAP was reviewed by sixteen elementary school teachers, using the evaluation questionnaire. The results of evaluation showed high average 3.60 (+/-0.52) points out of 4 while proving a reliable and valid school-based program. CONCLUSIONS: The SAP indicated that it may serve as a practical and substantive program for hearing-impaired children in the public school in order to help them achieve better academic support and social integrations.
Child ; Friends ; Hearing ; Hearing Loss* ; Humans ; Surveys and Questionnaires

OBJECTIVE: Alcohol use disorder (AUD) is one of the most frequent comorbid conditions in mood disorders. We aimed to examine the relationships between clinical phenotypes of acutely depressed subjects and co-occurring AUD.METHODS: Clinical assessment including diagnosis of mood disorder and co-occurring AUD, the severity of depressive or manic symptoms, and affective temperaments were conducted in 137 subjects suffering from a major depressive episode. According to the presence of AUD, clinical variables were compared between the two groups. Using binary logistic regression models, the effects of mood symptoms and affective temperaments on the risk of AUD were determined.RESULTS: Severity of manic symptoms, suicidal ideation, and childhood trauma were higher in the AUD group than in the non-AUD group. Scores for irritable and hyperthymic temperament were higher and the score for anxious temperament was lower in the AUD group. In regression models adjusting confounders, anxious temperament was an independent protector against AUD. On the other hand, the diagnosis of bipolar disorder and the irritable manic symptom dimension increased the risk of AUD.CONCLUSION: Anxious temperament decreased the AUD risk, whereas irritable manic symptoms increased the risk during depression. AUD in mood disorders may be an expression of manic psychopathology.
Bipolar Disorder ; Depression ; Diagnosis ; Hand ; Humans ; Logistic Models ; Mood Disorders ; Phenotype ; Psychopathology ; Suicidal Ideation ; Temperament

Objectives: This study investigates the association between short-term exposure to air pollutants and panic attacks requiring emergency department (ED) visits. Methods: We identified 1926 patients who visited EDs in Seoul with panic attacks as the primary cause during the period from 2008 to 2014. We estimated short-term exposure to particles <2.5 μm (PM2.5), particles <10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO). We applied a time-stratified case-crossover study design and conducted a conditional logistic regression analysis to assess the association between air pollutants levels and ED visits due to panic attacks. Results: Increasing O3 concentration was significantly associated with an increased risk of panic attacks requiring ED visits (odds ratio: 1.15; 95% confidence interval: 1.04–1.27) on the same day of exposure. This association was robust to the sensitivity analysis using two pollutant models. Conclusion Our results show that short-term exposure to elevated O3 concentration is associated with the exacerbation of panic attacks. This finding strongly suggests the detrimental effects of O3 on major public health problems and provides insights for further research to investigate the causal associations between air pollution and poor mental health.

Objectives: This study investigates the association between short-term exposure to air pollutants and panic attacks requiring emergency department (ED) visits. Methods: We identified 1926 patients who visited EDs in Seoul with panic attacks as the primary cause during the period from 2008 to 2014. We estimated short-term exposure to particles <2.5 μm (PM2.5), particles <10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO). We applied a time-stratified case-crossover study design and conducted a conditional logistic regression analysis to assess the association between air pollutants levels and ED visits due to panic attacks. Results: Increasing O3 concentration was significantly associated with an increased risk of panic attacks requiring ED visits (odds ratio: 1.15; 95% confidence interval: 1.04–1.27) on the same day of exposure. This association was robust to the sensitivity analysis using two pollutant models. Conclusion Our results show that short-term exposure to elevated O3 concentration is associated with the exacerbation of panic attacks. This finding strongly suggests the detrimental effects of O3 on major public health problems and provides insights for further research to investigate the causal associations between air pollution and poor mental health.

Background and Objectives: In distracting listening conditions, individuals need to pay extra attention to selectively listen to the target sounds. To investigate the amount of listening effort required in reverberating and noisy backgrounds, a semantic mismatch was examined. Subjects and Methods: Electroencephalography was performed in 18 voluntary healthy participants using a 64-channel system to obtain N400 latencies. They were asked to listen to sounds and see letters in 2 reverberated×2 noisy paradigms (i.e., Q-0 ms, Q-2000 ms, 3 dB-0 ms, and 3 dB-2000 ms). With auditory-visual pairings, the participants were required to answer whether the auditory primes and letter targets did or did not match. Results: Q-0 ms revealed the shortest N400 latency, whereas the latency was significantly increased at 3 dB-2000 ms. Further, Q-2000 ms showed approximately a 47 ms delayed latency compared to 3 dB-0 ms. Interestingly, the presence of reverberation significantly increased N400 latencies. Under the distracting conditions, both noise and reverberation involved stronger frontal activation. Conclusions The current distracting listening conditions could interrupt the semantic mismatch processing in the brain. The presence of reverberation, specifically a 2000 ms delay, necessitates additional mental effort, as evidenced in the delayed N400 latency and the involvement of the frontal sources in this study.

OBJECTIVE: Cytokines have been reported to have key roles in major depressive disorder (MDD). However, much less is known about cytokines in MDD and antidepressant treatment due to the diversity of cytokines and the heterogeneity of depression. We investigated the levels of cytokines in patients with MDD compared with healthy subjects and their associations with antidepressant response. METHODS: We investigated the changes of several cytokines (eotaxin, sCD40L, IL-8, MCP-1alpha, TNF-alpha, INF-gamma and MIP-1alpha) by Luminex assay in 66 patients with MDD and 22 healthy controls. The antidepressant response was assessed by 17-item Hamilton Rating Scale for Depression. RESULTS: We found the levels of sCD40L (p=0.001), IL-8 (p=0.004) and MCP-1 (p=0.03) of healthy controls were significantly higher than those of depressive patients. However, the level of eotaxin and TNF-alpha were not associated with MDD. In addition, we found the level of MCP-1 was significantly changed after antidepressant treatment (p=0.01). CONCLUSION: These findings suggest the roles of cytokines in MDD are complex, and could vary according to the individual characteristics of each patient. Further studies regarding the relationship between cytokines and MDD will be required.
Antidepressive Agents ; Cytokines ; Depression ; Depressive Disorder, Major* ; Healthy Volunteers ; Humans ; Immune System ; Interleukin-8 ; Population Characteristics ; Tumor Necrosis Factor-alpha

Clinical course of depression is variable. The serotonin transporter gene is one of the most studied genes for depression. We examined the association of serotonin transporter gene polymorphisms with chronicity and recurrent tendency of depression in Korean subjects. This cross-sectional study involved 252 patients with major depression. Patients were genotyped for s/l polymorphisms in 5-HTT promoter region (5-HTTLPR), s/l variation in second intron of the 5-HTT gene (5-HTT VNTR intron2). Chronicity was associated with 5-HTTLPR. Patients with l/l had higher rate of chronicity than the other patients (l/l vs s/l or s/s; odds ratio, 4.45; 95% confidence interval, 1.59-12.46; P=0.005; logistic regression analysis). Recurrent tendency was not associated with 5-HTTLPR. Chronicity and recurrent tendency were not associated with 5-HTT VNTR intron2. These results suggest that chronic depression is associated with 5-HTTLPR.
Aged ; Chronic Disease ; Cross-Sectional Studies ; Depression/*genetics ; Female ; Genotype ; Humans ; Introns ; Male ; Middle Aged ; Odds Ratio ; *Polymorphism, Genetic ; Promoter Regions, Genetic ; Recurrence ; Serotonin Plasma Membrane Transport Proteins/*genetics

OBJECTIVE: Caregivers for patients with Alzheimer's disease (AD) suffer from psychological and financial burdens. However, the results of the relationship between burden and cognitive function, performance of activities of daily living, and depressive symptoms have remained inconsistent. Therefore, the aim of this study was to examine which factors are more significant predictors of heightened burden, cognitive impairment or functional decline, besides neuropsychiatric symptoms. METHODS: A cross-sectional study was conducted in a sample comprised of 1,164 pairs of patients with AD and caregivers from the Clinical Research of Dementia of South Korea study cohorts. The cognitive function of each sub-domain, functional impairments, depressive symptoms, and caregiver burden were assessed using the dementia version of Seoul Neuropsychological Screening Battery (SNSB-D), Barthel Index for Daily Living Activities (ADL), Seoul-Instrumental Activities of Daily Living (S-IADL), the Clinical Dementia Rating Sum of Box (CDR-SB), the Global Deterioration Scale (GDS), the Korean version of the Neuropsychiatric Inventory (K-NPI), and the 15-item Geriatric Depression Scale. RESULTS: We found that higher severity (higher CDR-SB and GDS scores) and more functional impairment (lower ADL and higher S-IADL scores) were significantly associated with higher caregiver burden. In addition, depressive symptoms of patients (higher Geriatric Depression Scale scores) were associated with higher caregiver burden. CONCLUSION: Therefore, interventions to help maintain activities of daily living in patients with AD may alleviate caregiver burden and improve caregiver well-being.
Activities of Daily Living ; Alzheimer Disease* ; Caregivers* ; Cognition ; Cohort Studies ; Cross-Sectional Studies ; Dementia ; Depression ; Humans ; Korea ; Mass Screening ; Seoul

OBJECTIVE: Although evidence suggests that there is an increase in suicide rates in the general population following celebrity suicide, the rates are heterogeneous across celebrities and countries. It is unclear which is the more vulnerable population according to the effect sizes of celebrity suicides to general population. METHODS: All suicide victims in the general population verified by the Korea National Statistical Office and suicides of celebrity in South Korea were included for 7 years from 2005 to 2011. Effect sizes were estimated by comparing rates of suicide in the population one month before and after each celebrity suicide. The associations between suicide victims and celebrities were examined. RESULTS: Among 94,845 suicide victims, 17,209 completed suicide within one month after 13 celebrity suicides. Multivariate logistic regression analyses revealed that suicide victims who died after celebrity suicide were significantly likely to be of age 20-39, female, and to die by hanging. These qualities were more strongly associated among those who followed celebrity suicide with intermediate and high effect sizes than lower. Younger suicide victims were significantly associated with higher effect size, female gender, white collar employment, unmarried status, higher education, death by hanging, and night-time death. Characteristics of celebrities were significantly associated with those of general population in hanging method and gender. CONCLUSION: Individuals who commit suicide after a celebrity suicide are likely to be younger, female, and prefer hanging as method of suicide, which are more strongly associated in higher effect sizes of celebrity suicide.
Education ; Employment ; Female ; Humans ; Korea ; Logistic Models ; Single Person ; Suicide* ; Vulnerable Populations

OBJECTIVE: Both clinical and biological factors influence the course of depressive disorders. This study tested for associations between the brain-derived neurotrophic factor (BDNF) gene at the Val66Met locus and the course of major depressive disorder (MDD). METHODS: Three hundred ten Korean subjects (209 patients, 101 controls) were genotyped for rs6265 at nucleotide 196 (G/A), which produces an amino acid substitution at codon 66 (Val66Met) of the gene for BDNF. Course of illness was evaluated both by chronicity of current episode (episode duration >24 months) and by the lifetime history of recurrences. RESULTS: Patients with the Met/Met BDNF genotype had a significantly higher rate of chronic depression than all others. There was a significant dose effect of the Met allele on chronicity. Compared with the Val/Val genotype, the relative risk of chronicity was 1.67 for the Val/Met genotype, and 2.58 for the Met/Met genotype. Lifetime history of recurrent episodes was not related to BDNF genotypes but was significantly associated with younger age of onset and with a history of depression in first degree relatives. CONCLUSION: BDNF genotyping may be informative for anticipating chronicity in major depression.
Age of Onset ; Alleles ; Amino Acid Substitution ; Biological Factors ; Brain-Derived Neurotrophic Factor ; Codon ; Depression ; Depressive Disorder ; Depressive Disorder, Major ; Genotype ; Humans