Eating disorders impact on both physical and mental health with a profound disruption in the quality of life of adolescent. The prevalence of these disorders has been increasing in East Asia and over 10% of young people have some eating disorder related traits. Cultural changes such as the internalisation of the thin ideal predispose to eating disorders. The core features of eating disorders are the pursuit of weight loss and the resultant low body weight or compensatory behavior. The nutritional compromise of eating disorders, particularly anorexia nervosa, results in disruption in menstrual cycle, increased medical risks, and an eventual increase in mortality. The mortality rate of anorexia nervosa is 12 times the rate of healthy age-matched women. The underlying medical causes of the increased mortality rate were cardiovascular, endocrine, hematopoietic, autoimmune, respiratory, and urogenital in nature. High frequencies of medical complications in eating disorders emphasizes the importance of recognizing eating disorders as a medical risk in adolescent in Korea. Successful approaches to prevention against eating disorders have already been developed for adolescent in Europe. Public health interventions targeted at schools responsible for the care of adolescent (parents, teachers, college tutors) would be useful in Korea.
Adolescent ; Anorexia Nervosa ; Body Weight ; Bulimia Nervosa ; Eating ; Feeding and Eating Disorders ; Europe ; Far East ; Female ; Humans ; Korea ; Menstrual Cycle ; Mental Health ; Prevalence ; Public Health ; Quality of Life ; Weight Loss

OBJECTIVES: How dose the Journal of Korean Neuropsychiatric Association reconcile both the essential companion in clinical practice and the leading academic journal of general psychiatry? METHODS: I have been involving 2 projects of the British Journal of Psychiatry (BJP), the leading international journal of general psychiatry. The first is a comparison between papers that are seen by referees who are willing for their names to be closed to the authors of previous papers and those who do not wish their names to be closed. The second involves the rejection rates and long-term outcome of papers submitted from low and middle income countries (LAMI). RESULTS: Many referees of BJP were supportive of disclosure but not so much when it comes to the bad news. LAMI are contributing well to the psychiatric literature, though conclusions from the results can only be tentative in view of the relative small numbers. CONCLUSION: The BJP showed me that good journalism in an academic publication is not oxymoron. The criterion of the originality and the scientific reliability should remain uncompromised at any time and these should remain the clearest guides. I also would like our journal to be more excellence in clinical communication.
Disclosure ; Friends ; Humans ; Journalism ; Publications

OBJECTIVES: How dose the Journal of Korean Neuropsychiatric Association reconcile both the essential companion in clinical practice and the leading academic journal of general psychiatry? METHODS: I have been involving 2 projects of the British Journal of Psychiatry (BJP), the leading international journal of general psychiatry. The first is a comparison between papers that are seen by referees who are willing for their names to be closed to the authors of previous papers and those who do not wish their names to be closed. The second involves the rejection rates and long-term outcome of papers submitted from low and middle income countries (LAMI). RESULTS: Many referees of BJP were supportive of disclosure but not so much when it comes to the bad news. LAMI are contributing well to the psychiatric literature, though conclusions from the results can only be tentative in view of the relative small numbers. CONCLUSION: The BJP showed me that good journalism in an academic publication is not oxymoron. The criterion of the originality and the scientific reliability should remain uncompromised at any time and these should remain the clearest guides. I also would like our journal to be more excellence in clinical communication.
Disclosure ; Friends ; Humans ; Journalism ; Publications

As the physical abnormalities seen in eating disorders seem to be largely secondary to these patients' disturbed eating habits and their compromised nutritional state, most physical abnormalities associated with eating disorders are reversed by restoring healthy eating habits and sound nutrition. However, some medical consequences of eating disorders are irreversible or have later repercussions on health, especially those affecting the skeleton, the reproductive system, and the brain. Early medical intervention and psychiatric treatment are particularly important for those with or at risk of severe emaciation. Eating disorders are common among adolescent girls and young women and are associated with potentially serious medical complications, yet they often go undetected and untreated. All patients with eating disorders should be evaluated and treated for medical complications of the disease at the same time that psychotherapy and nutritional counseling are undertaken.

OBJECTIVES: This paper aims to understand the emotional-biological pathogenesis of eating disorders, and translate the understanding into new brain directed treatments. METHODS: The first part of the review sets the eating behavior into the context of what is now understood about the central control of appetite and molecular biology. The second part of the review sees how emotion relates to the brain circuit involving eating disorders. RESULTS: In general, patients with anorexia nervosa restricting type were less sensitive to reward, whereas patients with bulimia nervosa and anorexia nervosa binge purging type were more sensitive to it. The emotional life of people with eating disorders centers on food, weight, and shape. The abnormalities in social and emotional functioning both precede and persist outside of eating disorders. CONCLUSIONS: Research into understanding the biological framework of the brain in eating disorders suggests that abnormalities may exist in emotional and information processing. This aspect can be translated into novel brain-directed treatments, particularly in anorexia nervosa.
Anorexia Nervosa ; Appetite ; Automatic Data Processing ; Brain ; Bulimia Nervosa ; Feeding and Eating Disorders* ; Eating* ; Feeding Behavior ; Humans ; Molecular Biology ; Neurobiology ; Reward

As the physical abnormalities seen in eating disorders seem to be largely secondary to these patients' disturbed eating habits and their compromised nutritional state, most physical abnormalities associated with eating disorders are reversed by restoring healthy eating habits and sound nutrition. However, some medical consequences of eating disorders are irreversible or have later repercussions on health, especially those affecting the skeleton, the reproductive system, and the brain. Early medical intervention and psychiatric treatment are particularly important for those with or at risk of severe emaciation. Eating disorders are common among adolescent girls and young women and are associated with potentially serious medical complications, yet they often go undetected and untreated. All patients with eating disorders should be evaluated and treated for medical complications of the disease at the same time that psychotherapy and nutritional counseling are undertaken.
Adolescent ; Anorexia Nervosa ; Binge-Eating Disorder ; Brain ; Bulimia Nervosa ; Counseling ; Early Medical Intervention ; Eating ; Emaciation ; Feeding and Eating Disorders ; Female ; Humans ; Psychotherapy ; Skeleton

OBJECTIVES: Although breakfast is important to nutrition balance, prevention of overeating, and weight control, people in their 20s (males: 55.1%, females: 49.9%) were reported to have the highest rate of skipping breakfast in 2016 Korea Health Statistics. This study aims to examine dietary habits and nutrient intake depending on breakfast frequency among young women in Seoul. METHODS: The subjects were 655 young women in Seoul from August to October 2016, and the survey was performed by using a questionnaire that included general characteristics, dietary habits, and eating behavior. Body composition was determined by bioelectric impedance analysis. Nutritional status was examined by the 24-hour recall method. RESULTS: The participants were classified by breakfast intake frequency; ‘≥ 5 times/week (n=160)’, ‘1–4 times/week (n=327)’, and ‘breakfast skipping (n=168)’. The ‘breakfast skipping’ group had lower frequency and regularity of meals. In addition, the ‘breakfast skipping’ group had a higher frequency of eating-out and late-night meals. There was no difference in total calories between the ‘breakfast skipping’ group and other groups, but the ‘breakfast skipping’ group had significantly low carbohydrate and fiber intakes. The participants showed lower intakes of calories, fiber, vitamin A, vitamin C, niacin, folic acid, calcium, potassium, and zinc in comparison with recommended intakes. Especially, the ‘breakfast skipping’ group had significantly lower fiber, vitamin A, vitamin C, calcium, potassium levels compared to the ‘≥ 5 times/week’ group. For Mean Adequacy Ratio (MAR), the ‘breakfast skipping’ group recorded a ratio of 0.60, which was lower than those of other groups. Index of Nutritional Quality (INQ) including fiber, vitamin C, calcium and phosphorus were significantly lower in the breakfast skipper group, compared to the breakfast eater group. CONCLUSIONS: The ‘breakfast skipping’ group showed low regularity of meals and a high frequency of eating-out and late-night meals. The breakfast regular eater group showed high intake of micronutrients and quality of meals was high in general. Skipping breakfast could lower nutrient intake and quality of meals, which requires attention.
Ascorbic Acid ; Body Composition ; Breakfast ; Calcium ; Electric Impedance ; Feeding Behavior ; Female ; Folic Acid ; Food Habits ; Humans ; Hyperphagia ; Korea ; Meals ; Methods ; Micronutrients ; Niacin ; Nutritional Status ; Nutritive Value ; Phosphorus ; Potassium ; Seoul ; Vitamin A ; Zinc

OBJECTIVES: Although breakfast is important to nutrition balance, prevention of overeating, and weight control, people in their 20s (males: 55.1%, females: 49.9%) were reported to have the highest rate of skipping breakfast in 2016 Korea Health Statistics. This study aims to examine dietary habits and nutrient intake depending on breakfast frequency among young women in Seoul. METHODS: The subjects were 655 young women in Seoul from August to October 2016, and the survey was performed by using a questionnaire that included general characteristics, dietary habits, and eating behavior. Body composition was determined by bioelectric impedance analysis. Nutritional status was examined by the 24-hour recall method. RESULTS: The participants were classified by breakfast intake frequency; ‘≥ 5 times/week (n=160)’, ‘1–4 times/week (n=327)’, and ‘breakfast skipping (n=168)’. The ‘breakfast skipping’ group had lower frequency and regularity of meals. In addition, the ‘breakfast skipping’ group had a higher frequency of eating-out and late-night meals. There was no difference in total calories between the ‘breakfast skipping’ group and other groups, but the ‘breakfast skipping’ group had significantly low carbohydrate and fiber intakes. The participants showed lower intakes of calories, fiber, vitamin A, vitamin C, niacin, folic acid, calcium, potassium, and zinc in comparison with recommended intakes. Especially, the ‘breakfast skipping’ group had significantly lower fiber, vitamin A, vitamin C, calcium, potassium levels compared to the ‘≥ 5 times/week’ group. For Mean Adequacy Ratio (MAR), the ‘breakfast skipping’ group recorded a ratio of 0.60, which was lower than those of other groups. Index of Nutritional Quality (INQ) including fiber, vitamin C, calcium and phosphorus were significantly lower in the breakfast skipper group, compared to the breakfast eater group. CONCLUSIONS: The ‘breakfast skipping’ group showed low regularity of meals and a high frequency of eating-out and late-night meals. The breakfast regular eater group showed high intake of micronutrients and quality of meals was high in general. Skipping breakfast could lower nutrient intake and quality of meals, which requires attention.
Ascorbic Acid ; Body Composition ; Breakfast ; Calcium ; Electric Impedance ; Feeding Behavior ; Female ; Folic Acid ; Food Habits ; Humans ; Hyperphagia ; Korea ; Meals ; Methods ; Micronutrients ; Niacin ; Nutritional Status ; Nutritive Value ; Phosphorus ; Potassium ; Seoul ; Vitamin A ; Zinc

Nowadays, it is apparent that personality disorder is a common condition. Some of the concepts of personality disorder that are currently in use are flawed and need to be revised. The aim of this article is to discuss the controversy created by the uncertainties in the current classification system and to suggest ways forward. In particular, the clinician needs to be aware of the importance of assessing personality abnormality in terms of a severity dimension, and of the ways in which such an abnormality can impact on treatments for other conditions. These changes in the notion of personality disorder are needed as, for the first time, a good evidence base is being established for potential treatments and these will be maximized if we have a classification fit for therapeutic purpose.
Personality Disorders

OBJECTIVES: The Personality Belief Questionnaire-Short Form (PBQ-SF) is a self-report instrument for assessment of dysfunctional beliefs based on Beck's cognitive formulations of personality disorders. The aims of this study was to examine the reliability and validity of the Korean version of PBQ-SF in clinical samples. METHODS: The Korean version of PBQ-SF was examined in 115 participants (50 patients with personality disorder and 65 patients without personality disorder). All participants were assessed for personality disorder using the semi-structured clinical interview of the Personality Assessment Schedule. The construction validity was examined by correlation with Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Neuroticism-Extraversion-Openness Five-Factor Inventory neuroticism scales. Twenty four randomly sampled patients were examined for the test-retest reliability. RESULTS: The Korean version of PBQ-SF showed good internal consistency [Cronbach's alpha=0.73 (schizoid)-0.92 (paranoid)] and test-retest reliability [r=0.74 (narcissistic)-0.92 (paranoid)]. The PBQ-SF was correlated with depression, anxiety, and neuroticism. The overall subscales of PBQ-SF were correlated with Diagnostic and Statistical Manual of Mental Disorders based diagnosis of personality disorders. CONCLUSION: Consistent with previous findings using the Korean full version of PBQ as well as the English version of PBQ-SF, our results support that the Korean version of PBQ-SF is a reliable and valid instrument for assessment of dysfunctional beliefs associated with personality pathology.
Anxiety ; Appointments and Schedules ; Depression ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Pathology ; Personality Assessment ; Personality Disorders ; Reproducibility of Results ; Weights and Measures