1.The Role and Effectiveness of Remote Mental Health Interventions in Disaster Response: A Narrative Review
Ah Rah LEE ; Sung Moon CHOI ; Myungjae BAIK ; Jong-Woo PAIK
Psychiatry Investigation 2026;23(1):5-10
Objective:
Disasters such as pandemics and natural catastrophes cause significant psychological distress, increasing the risk of depression, anxiety, and post-traumatic stress disorder (PTSD). This review aimed to evaluate the effectiveness of remote mental health interventions, such as telepsychiatry, online cognitive behavioral therapy (CBT), mobile applications, and artificial intelligence (AI)-based tools, during disasters.
Methods:
A comprehensive literature search was conducted using international databases (PubMed, EMBASE, PsycINFO, Web of Science, Scopus, CINAHL) and Korean domestic databases (KISS, RISS, DBpia, KMbase, KoreaMed). Studies published between January 2010 and February 2025 were screened following the PRISMA 2020 guidelines. Two board-certified psychiatrists independently reviewed titles, abstracts, and full texts. Peer-reviewed articles and relevant grey literature, including government manuals and expert guidelines, were included.
Results:
A total of 147 studies were synthesized, including randomized controlled trials, meta-analyses, observational studies, and policy documents. Evidence showed that remote interventions effectively reduced symptoms of depression, anxiety, and PTSD. Online CBT was beneficial for mild to moderate distress; mobile apps facilitated psychoeducation and symptom tracking; and telepsychiatry ensured care continuity, especially in underserved areas. AI tools showed promise in screening and triage but require better clinical integration. Effectiveness was highest when interventions were implemented early, integrated within stepped-care models, and guided by trained professionals.
Conclusion
Remote mental health interventions are practical and effective tools for bridging mental health care gaps during disasters. To ensure sustainability, these interventions should be integrated into national disaster mental health frameworks, accompanied by adequate funding, clinician training, legal safeguards, and cultural adaptation.
2.Suicide Prevention in Hospitals: A Survey of Patient Safety Management Specialists
Haelim LEE ; Ah Rah LEE ; Sung Moon CHOI ; Siyeun YOON ; Myungjae BAIK ; Sang Min LEE ; Jong-Woo PAIK
Journal of Korean Neuropsychiatric Association 2025;64(4):297-305
Objectives:
This study examined the experiences and perceptions of healthcare safety management specialists regarding suicide and self-harm incidents in hospitals. The aim was to assess the current state of in-hospital suicide prevention systems, identify vulnerabilities according to the institution type, and suggest directions for improving the related policies and safety guidelines.
Methods:
A nationwide cross-sectional survey was conducted among 152 healthcare safety management specialists. Data were collected via an online questionnaire between May and June 2022. The survey items included experiences with suicide and self-harm incidents, types of incidents, components of prevention systems, staff training, and follow-up measures. Descriptive and inferential statistics were used for analysis, including chi-square tests for comparisons across hospital types.
Results:
The most frequently reported suicide methods were hanging (40.1%) and jumping (28.3%), while self-harm incidents often involved self-injury (45.4%). Only 55.3% of respondents indicated that institutional guidelines on suicide/self-harm were present and implemented. Multidisciplinary treatment planning and suicide prevention education for all staff were lacking, showing 32.2% and 27.6%, respectively. Significant differences were observed across hospital types regarding the existence and implementation of prevention guidelines (p<0.01).
Conclusion
Despite the increasing awareness, substantial variability remains in suicide prevention preparedness across hospital types. Strengthening institutional guidelines, environmental modifications, and multidisciplinary approaches, particularly in nursing hospitals, is critical. Policy support for standardizing mental health consultations and mandatory staff training is essential for enhancing suicide prevention in hospitals.
3.Factors Affecting Clozapine Adherence in Patients With Schizophrenia: A Qualitative Study
Sung Moon CHOI ; Myung Jae BAIK ; Won Sub KANG ; Ah Rah LEE ; Jong Woo PAIK ; Sang Min LEE
Journal of Korean Neuropsychiatric Association 2025;64(4):277-288
Objectives:
This study examined the psychosocial factors that influence the continuation of clozapine use among individuals with schizophrenia. This examination was conducted through indepth qualitative interviews.
Methods:
Thirty-one adults diagnosed with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) who had been taking Clozapine ® for at least 3 months were interviewed. Data were collected from May to October 2024 and analyzed using Braun and Clarke’s thematic analysis.
Results:
Two overarching themes emerged: 1) transformation of perceptions and engagement with treatment, including initial resistance stemming from severe symptoms and lack of insight, experiences of coercive interventions, rebuilding trust in the mental health system, and evolving attitudes toward psychiatric medications; and 2) personal recovery and social support, encompassing coping with side effects, recognizing symptom improvement and renewed hope, and the pivotal roles of family and therapeutic alliance. Trust in healthcare providers and emotional support from family were central to sustained adherence to clozapine.
Conclusion
Sustained clozapine use in schizophrenia patients is influenced by intertwined psychological, relational, and contextual factors. Acceptance of treatment was supported by symptom improvement, family support, and trust in healthcare providers. These elements contributed to medication adherence and broader functional recovery. A person-centered, integrated approach is essential to promote continued use and long-term outcomes.
4.Association Between Gene Polymorphisms of RSPO2 of the Wnt Signaling Pathway and Schizophrenia in the Korean Population
Ah Rah LEE ; Hae Jeong PARK ; Won Sub KANG ; Jong Woo KIM
Psychiatry Investigation 2025;22(12):1339-1349
Objective:
The study aimed to investigate whether RSPO2 gene polymorphisms are associated with schizophrenia susceptibility, focusing on five specific single nucleotide polymorphisms (SNPs). Additionally, the study evaluated the expression of Rspo2 in a schizophrenic-like mouse model and examined its relationship with clinical symptoms.
Methods:
The study included 159 schizophrenia patients and 448 controls. Clinical symptoms were assessed using the Operational Criteria Checklist for Psychotic Illness. Genotyping of five RSPO2 SNPs was performed to identify potential genetic associations with schizophrenia. Rspo2 mRNA expression levels were measured in the brains of MK-801-induced schizophrenic-like mice. Functional analysis of the rs374810 SNP was conducted using a luciferase assay to evaluate its effect on gene activity. Statistical analyses were used to compare genotype and allele frequencies and assess correlations with clinical outcomes.
Results:
Significant associations were found between schizophrenia and two SNPs, rs374810 and rs423940. The A allele of rs374810 and the T allele of rs423940 were linked to an increased risk of schizophrenia (p=0.0049 and p=0.0044, respectively). Functional analysis revealed that the A allele of rs374810 significantly increased luciferase activity compared to the G allele, indicating a potential functional role. RSPO2 expression was also altered in the schizophrenic-like mouse model, suggesting its involvement in schizophrenia pathogenesis.
Conclusion
The findings indicate that RSPO2 gene polymorphisms, particularly rs374810 and rs423940, may contribute to schizophrenia susceptibility. Therefore, RSPO2 expression may be associated with the susceptibility to schizophrenia in the Korean population.
5.Can Pre-Transplant Psychometric Testing Predict Tacrolimus Intrapatient Variability After Living Kidney Transplantation?
Ah Rah LEE ; Sang Min LEE ; Won Sub KANG ; Ah Rang CHO ; Jong Woo KIM ; Jin Kyung PARK
Psychiatry Investigation 2024;21(7):718-725
Objective:
Tacrolimus intrapatient variability (Tac IPV) has been considered a marker for post-graft risk. We investigated pre-transplant psychometric testing to predict Tac IPV after living kidney transplantation.
Methods:
Minnesota Multiphasic Personality Inventory-2 (MMPI-2) examined during pre-transplant evaluation by 102 recipients were analyzed. Subjects were divided into two groups, low IPV (L-IPV) and high IPV (H-IPV), by cutoffs of Tac IPV: median of 24 and value of 30. T-scores of MMPI-2 scales were used to analyze difference between L-IPV and H-IPV using independent t-tests. Stepwise multiple logistic regression was used to test whether MMPI-2 scales affected Tac IPV. Confusion matrix of logistic regression was used to explain statistical power. Cutoff values of significant scales for H-IPV were analyzed by constructing receiver operating characteristic curves.
Results:
Hysteria (Hy) and depression (D) scale scores and Tac IPV were associated in IPV 24 (odds ratio [OR]: 1.08, p<0.01 for Hy; OR: 0.93, p<0.01 for D) and IPV 30 models (OR: 1.09, p<0.01 for Hy; OR: 0.92, p<0.01 for D). Paranoia (Pa) scale scores were associated with Tac IPV in IPV 24 model (OR=1.10, p<0.01) and were significantly higher in H-IPV 24 (p<0.01). F1 scores of confusion matrix in IPV 24 and 30 models were 0.70 and 0.71, respectively. Cutoffs of Hy, D, and Pa scales were 51, 57, and 47, respectively.
Conclusion
MMPI-2 profile is suggested as a predictor for high Tac IPV after living kidney transplantation.
6.Stigma Experience and Mental Health of Vulnerable Groups:Focusing on the COVID-19 Period
Sung Moon CHOI ; Jong-Woo PAIK ; Myung Jae PAIK ; Jin Hee HYUN ; Sung Eun YOU ; Ah Rah LEE ; Sang Min LEE
Journal of Korean Neuropsychiatric Association 2024;63(4):225-236
Objectives:
This study explored the stigma and mental health challenges that vulnerable populations faced during COVID-19 using in-depth interviews with 32 participants.
Methods:
A generic qualitative methodology was employed, with data collected via face-to-face and Zoom interviews conducted from March to August 2021.
Results:
Two major themes emerged: the nature of stigmatization and mental health impacts.The participants reported increased exposure to personal information, worsening institutional stigmatization, and routine social exclusion, leading to internalized stigma. They experienced extreme fear, anxiety, depression, hopelessness, suicidal thoughts, and declining physical health.
Conclusion
The results underscore the necessity of a comprehensive mental health support system that integrates psychological interventions, stigma prevention education, anti-stigma initiatives, and customized policies. Future research should investigate the prolonged impact of pandemic-induced stigma and devise effective strategies for support and intervention.
7.Stigma Experience and Mental Health of Vulnerable Groups:Focusing on the COVID-19 Period
Sung Moon CHOI ; Jong-Woo PAIK ; Myung Jae PAIK ; Jin Hee HYUN ; Sung Eun YOU ; Ah Rah LEE ; Sang Min LEE
Journal of Korean Neuropsychiatric Association 2024;63(4):225-236
Objectives:
This study explored the stigma and mental health challenges that vulnerable populations faced during COVID-19 using in-depth interviews with 32 participants.
Methods:
A generic qualitative methodology was employed, with data collected via face-to-face and Zoom interviews conducted from March to August 2021.
Results:
Two major themes emerged: the nature of stigmatization and mental health impacts.The participants reported increased exposure to personal information, worsening institutional stigmatization, and routine social exclusion, leading to internalized stigma. They experienced extreme fear, anxiety, depression, hopelessness, suicidal thoughts, and declining physical health.
Conclusion
The results underscore the necessity of a comprehensive mental health support system that integrates psychological interventions, stigma prevention education, anti-stigma initiatives, and customized policies. Future research should investigate the prolonged impact of pandemic-induced stigma and devise effective strategies for support and intervention.
8.Stigma Experience and Mental Health of Vulnerable Groups:Focusing on the COVID-19 Period
Sung Moon CHOI ; Jong-Woo PAIK ; Myung Jae PAIK ; Jin Hee HYUN ; Sung Eun YOU ; Ah Rah LEE ; Sang Min LEE
Journal of Korean Neuropsychiatric Association 2024;63(4):225-236
Objectives:
This study explored the stigma and mental health challenges that vulnerable populations faced during COVID-19 using in-depth interviews with 32 participants.
Methods:
A generic qualitative methodology was employed, with data collected via face-to-face and Zoom interviews conducted from March to August 2021.
Results:
Two major themes emerged: the nature of stigmatization and mental health impacts.The participants reported increased exposure to personal information, worsening institutional stigmatization, and routine social exclusion, leading to internalized stigma. They experienced extreme fear, anxiety, depression, hopelessness, suicidal thoughts, and declining physical health.
Conclusion
The results underscore the necessity of a comprehensive mental health support system that integrates psychological interventions, stigma prevention education, anti-stigma initiatives, and customized policies. Future research should investigate the prolonged impact of pandemic-induced stigma and devise effective strategies for support and intervention.
9.Stigma Experience and Mental Health of Vulnerable Groups:Focusing on the COVID-19 Period
Sung Moon CHOI ; Jong-Woo PAIK ; Myung Jae PAIK ; Jin Hee HYUN ; Sung Eun YOU ; Ah Rah LEE ; Sang Min LEE
Journal of Korean Neuropsychiatric Association 2024;63(4):225-236
Objectives:
This study explored the stigma and mental health challenges that vulnerable populations faced during COVID-19 using in-depth interviews with 32 participants.
Methods:
A generic qualitative methodology was employed, with data collected via face-to-face and Zoom interviews conducted from March to August 2021.
Results:
Two major themes emerged: the nature of stigmatization and mental health impacts.The participants reported increased exposure to personal information, worsening institutional stigmatization, and routine social exclusion, leading to internalized stigma. They experienced extreme fear, anxiety, depression, hopelessness, suicidal thoughts, and declining physical health.
Conclusion
The results underscore the necessity of a comprehensive mental health support system that integrates psychological interventions, stigma prevention education, anti-stigma initiatives, and customized policies. Future research should investigate the prolonged impact of pandemic-induced stigma and devise effective strategies for support and intervention.
10.Psychosocial Pre-Transplant Assessment of Living Kidney Donors
Ah Rah LEE ; Myungjae BAIK ; Sang Min LEE ; Won Sub KANG ; Jin Kyung PARK
Korean Journal of Psychosomatic Medicine 2023;31(2):43-49
In Korea, the dependence on living donations is high due to the shortage of organs available for donation compared to the number of people waiting for transplants and the number of living organ donations continues to increase. In particular, the number of living-donor transplantations is high worldwide, highlighting the importance of pre-transplant psychosocial evaluation of living kidney donors. According to previous studies, when evaluating living organ donors before transplantation, it is crucial to determine whether the donor can give informed consent and be aware of the risks after surgery. Pre-transplant evaluation tests such as ELPAT living organ donor Psychological Assessment Tool (EPAT), Live Donor Assessment Tool (LDAT), Living Donation Expectancies Questionnaire (LDEQ), Minnesota Multiphasic Personality Inventory-2 questionnaire (MMPI-2) and Temperament and Character Inventory (TCI) are conducted for donors. After reviewing the literature on these pre-transplant psychosocial assessment tools, we will also look at legal considerations for living kidney donors in Korea and suggest an effective and essential pre-transplant screening evaluation method for living kidney transplant donors.

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