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Depression as a Mediator of the Relationship Between Resilience and Posttraumatic Stress Symptoms and Dissociation in Firefighters.

Tae Hoon KWON ; So Yeon HYUN ; Young Ki CHUNG ; Ki Young LIM ; Jae Sung NOH ; Dae Ryong KANG ; Gwiyeom HA ; Nam Hee KIM

Korean Journal of Psychosomatic Medicine.2016;24(1):109-116.

OBJECTIVES: This study aimed to investigate the effects of resilience on posttraumatic stress symptoms and dissociation and whether depression mediates the relationships between resilience and posttraumatic stress symptoms and dissociation. METHODS: A total of 115 firefighters participated in the study. Data were collected via the Life Events Checklist, Impact of Event Scale-Revised, Dissociative Experience Scale, Beck Depression Inventory, and Connor-Davidson Resilience Scale. Structural equation modeling and path analysis were applied to estimate the relationships between resilience, depression, posttraumatic stress symptoms, and dissociation. RESULTS: Greater resilience was associated with lower posttraumatic stress symptoms and dissociation, and the relationship between them was fully mediated by depression. CONCLUSIONS: Specific aspects of depression may help explain the relationships between resilience and posttraumatic stress symptoms and dissociation. Tailored prevention programs and treatments based on resilience and depression may prevent posttraumatic stress symptoms and dissociation in firefighters and improve treatments outcomes among firefighters with posttraumatic stress symptoms and/or dissociation.
Checklist ; Depression* ; Firefighters* ; Humans

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The Effect of Bilateral Eye Movements on Face Recognition in Patients with Schizophrenia.

Na Hyun LEE ; Ji Woong KIM ; Woo Young IM ; Sang Min LEE ; Sanghyun LIM ; Hyukchan KWON ; Min Young KIM ; Kiwoong KIM ; Seung Jun KIM

Korean Journal of Psychosomatic Medicine.2016;24(1):102-108.

OBJECTIVES: The deficit of recognition memory has been found as one of the common neurocognitive impairments in patients with schizophrenia. In addition, they were reported to fail to enhance the memory about emotional stimuli. Previous studies have shown that bilateral eye movements enhance the memory retrieval. Therefore, this study was conducted in order to investigate the memory enhancement of bilaterally alternating eye movements in schizophrenic patients. METHODS: Twenty one patients with schizophrenia participated in this study. The participants learned faces (angry or neutral faces), and then performed a recognition memory task in relation to the faces after bilateral eye movements and central fixation. Recognition accuracy, response bias, and mean response time to hits were compared and analysed. Two-way repeated measure analysis of variance was performed for statistical analysis. RESULTS: There was a significant effect of bilateral eye movements condition in mean response time(F=5.812, p<0.05) and response bias(F=10.366, p<0.01). Statistically significant interaction effects were not observed between eye movement condition and face emotion type. CONCLUSIONS: Irrespective of the emotional difference of facial stimuli, recognition memory processing was more enhanced after bilateral eye movements in patients with schizophrenia. Further study will be needed to investigate the underlying neural mechanism of bilateral eye movements-induced memory enhancement in patients with schizophrenia.
Bias (Epidemiology) ; Eye Movements* ; Humans ; Memory ; Reaction Time ; Schizophrenia*

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Association of Hemoglobin Levels and Cognitive Function in Alzheimer's Disease and Mild Cognitive Impairment.

Joon Kyung PARK ; Kang Joon LEE ; Hyun KIM

Korean Journal of Psychosomatic Medicine.2016;24(1):94-101.

OBJECTIVES: Anemia is a common problem in the management of elderly patients. Recent studies reported that anemia was associated with cognitive impairment and Alzheimer's disease. This study was aimed to analyze the differences of hemoglobin levels in Korean patients with Alzheimer's disease(AD) dementia, mild cognitive impairment(MCI), and healthy controls. Furthermore, the study also examined if any association between hemoglobin levels and cognitive functions existed. METHODS: A total of 116 Korean elderly adults were participated in this study(mean age 74.67 years ; 60.3% female). The Korean version of the Mini-Mental State Examination(MMSE-K), Clinical Dementia Rating(CDR) and Global Deterioration Scale(GDS) were applied to all subjects. Hematological and related blood chemistry values were investigated. RESULTS: We found that patients with AD dementia had significantly lower hemoglobin and hematocrit levels than MCI subjects and healthy control group. The hemoglobin levels showed a positive correlation with MMSE-K and negative correlation with CDR, GDS. CONCLUSIONS: Among Korean elderly, low hemoglobin level is associated with a cognitive impairment. This study indicates that AD is associated with anemia, and low hemoglobin levels may contribute to potentially useful clinical markers of AD. The risk factor for dementia needs to be confirmed by prospective longitudinal studies in a larger group of patients.
Adult ; Aged ; Alzheimer Disease* ; Anemia ; Biomarkers ; Chemistry ; Cognition Disorders ; Cognition* ; Dementia ; Hematocrit ; Humans ; Longitudinal Studies ; Mild Cognitive Impairment* ; Prospective Studies ; Risk Factors

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Validation of the Korean version of Center for Epidemiologic Studies Depression Scale-Revised(K-CESD-R).

San LEE ; Seung Taek OH ; So Yeon RYU ; Jin Yong JUN ; Kounseok LEE ; Eun LEE ; Jin Young PARK ; Sang Wook YI ; Won Jung CHOI

Korean Journal of Psychosomatic Medicine.2016;24(1):83-93.

OBJECTIVES: The Center for Epidemiologic Studies Depression scale-Revised is a recently revised scale which has been reported as a valid tool for the assessment of depressive symptoms. It encompasses cardinal symptoms of depression described in the Diagnostic and Statistical Manual of Mental disorders, fourth edition. In this study, we assessed the reliability, validity and psychometric properties of the Korean version of the CESD-R(K-CESD-R). METHODS: Forty-eight patients diagnosed as major depressive disorder, dysthymia, depressive disorder NOS according to the DSM-IV criteria using Mini International Neuropsychiatric Interview and 48 healthy controls were enrolled in this study. They were assessed with K-CESD-R, K-MADRS, PHQ-9, KQIDS-SR, STAI to check cross-validation. Statistical analyses were performed using calculation of Cronbach's alpha, Pearson correlation coefficient, Principal Component Analysis, ROC curve and optimal cut-off value. RESULTS: The Cronbach's alpha of K-CESD-R was 0.98. The total score of K-CESD-R revealed significantly high correlations with those of K-MADRS, PHQ-9, KQIDS-SR(r=0.910, 0.966 and 0.920, p<0.001, respectively). Factor analysis showed two factors account for 76.29% of total variance. We suggested the optimal cut-off value of K-CESD-R as 13 according to analysis of the ROC curve which value sensitivity and specificity both equally. CONCLUSIONS: These Results showed that the K-CESD-R could be a reliable and valid scale to assess depressive symptoms. The K-CESD-R is expected as a useful and effective tool for screening and measuring depressive symptoms not only in outpatient clinic but also epidemiologic studies.
Ambulatory Care Facilities ; Depression* ; Depressive Disorder ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiologic Studies* ; Humans ; Mass Screening ; Principal Component Analysis ; Psychometrics ; ROC Curve ; Sensitivity and Specificity

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Severity of Comorbidities among Suicidal Attempters Classified by the Forms of Psychiatric Follow-up.

Hyeok LEE ; Seung Taek OH ; Min Kyeong KIM ; Seon Koo LEE ; Jeong Ho SEOK ; Won Jung CHOI ; Byung Ook LEE

Korean Journal of Psychosomatic Medicine.2016;24(1):74-82.

OBJECTIVES: Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. METHODS: One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. RESULTS: Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. CONCLUSIONS: Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.
Ambulatory Care Facilities ; Comorbidity* ; Decision Making ; Emergency Service, Hospital ; Employment ; Follow-Up Studies* ; Gyeonggi-do ; Hospitals, General ; Humans ; Medical Records ; Mental Disorders ; Mortality ; Outpatients ; Psychiatry ; Retrospective Studies ; Suicide

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A Study of Effects of Psychosocial Factors and Quality of Life on Functional Dyspepsia in Firefighters.

Seung Ho JANG ; Han Seung RYU ; Suck Chei CHOI ; Hye Jin LEE ; Sang Yeol LEE

Korean Journal of Psychosomatic Medicine.2016;24(1):66-73.

OBJECTIVES: The purpose of this study was to investigate the characteristics of psychosocial factors related to functional dyspepsia(FD) and their effects on quality of life(QOL) in firefighters. METHODS: This study examined data collected from 1,217 firefighters. We measured psychological symptoms by Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder questionnaire(GAD-7), Korean Occupational Stress Scale(KOSS), Ways of Coping checklist(WCCL), Rosenberg's Self-Esteem Scale(RSES) and World Health Organization Quality of Life Scale abbreviated version(WHOQOL-BREF). Chi-square test, independent t-test, Pearson's correlation test, logistic regression analysis, and hierarchical regression analysis were used as statistical analysis methods. RESULTS: For the group with FD, the male participants showed significantly higher frequency(p=0.006) compared to the female participants. The group with FD had higher scores for depressive symptoms(p<.001), anxiety (p<.001), and occupational stress(p<.001), and did lower scores for self-esteem(p=.008), quality of life(p<.001) than those without FD. The FD risk was higher in the following KOSS subcategories: job demand(OR 1.94, 95% CI : 1.29-2.93), lack of reward(OR 2.47, 95% CI : 1.61-3.81), and occupational climate(OR 1.51, 95% CI : 1.01-2.24). In the hierarchical regression analysis, QOL was best predicted by depressive symptoms, self-esteem, and occupational stress. Three predictive variables above accounts for 42.0% variance explained of total variance. CONCLUSIONS: The psychosocial factors showed significant effects on FD, and predictive variables for QOL were identified based on regression analysis. The results suggest that the psychiatric approach should be accompanied with medical approach in future FD assessment.
Anxiety ; Anxiety Disorders ; Depression ; Dyspepsia* ; Female ; Firefighters* ; Humans ; Logistic Models ; Male ; Psychology* ; Quality of Life* ; World Health Organization

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The Differences of Serum Homocysteine Levels in Mild Cognitive Impairment and Dementia of Alzheimer's Type with or without Depressive Symptoms.

Ram HWANGBO ; Hyun KIM ; Kang Joon LEE

Korean Journal of Psychosomatic Medicine.2014;22(1):40-45.

OBJECTIVES: Mild cognitive impairment(MCI) and dementia of Alzheimer's type(AD) are characterized by progressive decline of cognitive abilities and a wide range of neuropsychiatric symptoms like depression. Among various diagnostic tools of AD, many studies showed that elevated levels of serum total homocysteine are associated with increased risk of developing Alzheimer's disease, depression and other neuropsychiatric disorders. We investigated whether elevated homocysteine concentrations are associated with depressive symptoms in MCI and AD. METHODS: A total of 86 patients diagnosed with MCI or AD participated. Total serum homocysteine levels in fasting blood samples were measured. We examined cognitive symptoms by MMSE-KC, Global Deterioration Scale(GDS), Clinical dementia rating(CDR) and depressive symptoms by Korean version of Geriatric Depression Scale(K-GDS). RESULTS: The total serum homocysteine levels were significantly higher in MCI with depression than in MCI without depression. There was no significant difference in the mean homocysteine levels between AD patients with depression and AD patients without depression. The total homocysteine levels showed a negative correlation with MMSE-KC and a positive correlation with CDR, GDS. CONCLUSIONS: These findings suggest that elevated homocysteine level is a risk factor for the decline of cognitive function and depression. We found a significant relationship between elevated serum homocysteine level and depressive symptoms in MCI. But our study had several limitations, thus more research is needed to confirm this finding.
Alzheimer Disease ; Dementia* ; Depression* ; Fasting ; Homocysteine* ; Humans ; Mild Cognitive Impairment* ; Neurobehavioral Manifestations ; Risk Factors

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Clinical Characteristics and Use of Psychotropic Agents among HIV-Infected/AIDS Patients Referred for Psychiatric Consultation.

Sang Ho SHIN ; Hyun Chung KIM ; So Young YOO ; Hyoung Shik SHIN ; Sung Doo WON ; So Hee LEE

Korean Journal of Psychosomatic Medicine.2014;22(1):31-39.

OBJECTIVES: This study aimed to investigate the psychiatric status of HIV-infected/AIDS inpatients in a general hospital over the past 2.5 years. METHODS: A retrospective chart review was conducted of psychiatric consultations performed between January 1, 2011, and July 30, 2013. The records of 97 HIV-infected/AIDS patients were analyzed. These included a total of 282 psychiatric consultations. RESULTS: Of the 97 patients, 91(93.8%) were male, the mean age was 48 years, and mean number of consultations was 2.8. Depressed mood was reported in 102 consultations(23.8%), insomnia in 60(14.0%), and anxiety in 31(7.2%). Psychiatric disorders diagnosed on initial consultation included depressive disorder(37 patients ; 37.0%), cognitive disorder(11 ; 11.0%), and delirium(9 ; 9.0%). Recommended psychotropic medication included Lorazepam(99 ; 17.2%), Escitalopram(90 ; 15.7%), and Quetiapine(84 ; 14.6%). CONCLUSIONS: The main complaints of HIV-infected/AIDS patients were depressed mood, insomnia, and suicidal ideation(including suicide attempts). In total, 85(93.3%) patients of those consulted were diagnosed as meeting the criteria for a psychiatric condition. However, considering that only 16.9% of patients consulted received follow-up treatment, longitudinal research is needed to examine the influence of psychiatric disorders on the transmission of HIV-infection/AIDS, as well as on prognosis and treatment adherence.
Anxiety ; Follow-Up Studies ; HIV ; Hospitals, General ; Humans ; Inpatients ; Male ; Prognosis ; Referral and Consultation ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders ; Suicide

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Correlation of Behavioral and Psychological Symptoms and Homocysteine in Patients with Dementia of Alzheimer's Type.

Ji Min LEE ; Woo Young IM ; Hyun KIM ; Kang Joon LEE

Korean Journal of Psychosomatic Medicine.2014;22(1):23-30.

OBJECTIVES: Homocysteine has been associated with cognitive impairment and various psychiatric symptoms. This study was designed to examine the relationship exists between plasma homocysteine concentration and behavioral and psychological symptoms of dementia(BPSD). METHODS: 41 subjects with dementia of Alzheimer's type were included in this study. We carried out history taking, physical examination, and cognitive assessment for the diagnosis of dementia of Alzheimer's type based on DSM-IV. We scored the Mini Mental State Examination(MMSE), Global Deterioration Scale(GDS), Clinical Dementia Rating(CDR), and the Korean Neuropsychiatric Inventory(K-NPI). We also measured levels of homocysteine, folate, and vitamin B12 in the plasma. RESULTS: We found statistically significant positive correlations between homocysteine concentration with NPI total score, and with scores of several sub-domains such as delusion, agitation/aggression, depression/dysphoria, and elation/euphoria. No significant correlation existed between homocysteine levels and scores of MMSE, GDS, and CDR. CONCLUSIONS: This study shows that plasma homocysteine levels are associated with BPSD. Further research is necessary to identify pathophysiologic mechanisms underlying these relationships.
Delusions ; Dementia* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Folic Acid ; Homocysteine* ; Humans ; Physical Examination ; Plasma ; Vitamin B 12

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Psychosocial Factors Predicting Delayed Diagnosis of Breast Cancer: The Role of Marital Relationship Functioning.

Ji Young KIM ; Jungmin WOO ; Sang Shin LEE ; Hea Won KIM ; Dongwoo KHANG ; Hyo Deog RIM

Korean Journal of Psychosomatic Medicine.2014;22(1):13-22.

OBJECTIVES: Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. METHODS: Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. RESULTS: Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p< 0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after di-agnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. CONCLUSIONS: We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.
Breast ; Breast Neoplasms* ; Delayed Diagnosis* ; Diagnosis ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Logistic Models ; Mammography ; Marriage* ; Mass Screening ; Mortality ; Psychology* ; Risk Factors ; Time-to-Treatment

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