Objective: Cognitive impairment is common in patients with Parkinson’s disease (PD), and few pharmacological options are available for treating this condition. We evaluated the effects of a digital cognitive training program (SUPERBRAIN), which was previously shown to be effective in populations at risk of Alzheimer’s disease, on cognitive function in individuals with PD. Methods: Twenty-three individuals with PD and mild cognitive impairment (PD-MCI) from four clinics were randomized to the intervention (n=16) or control (n=7) groups. The intervention group completed a 12-week, home-based, tablet-based cognitive training program (25–30 min/day, 7 days/week). Cognitive outcomes were assessed using the Seoul Neuropsychological Screening Battery pre- and post-intervention. Results: The adherence rate was 79.36%. The intervention group showed significant improvements in the Seoul Verbal Learning Test (SVLT) delayed recall and the Controlled Oral Word Association Test, while no changes were observed in the control group. Analysis of covariance confirmed greater SVLT improvement in the intervention group (F statistic=7.15, p=0.015, partial η2=0.28). Conclusion SUPERBRAIN is feasible and can improve cognitive function in individuals with PD-MCI.

Objectives: ：This study aimed to investigate the effects of anxiety sensitivity and distress overtolerance onposttraumatic stress symptoms (PTSS), and examined the role of brooding and reflection as a mediator. Methods: ：A self-reported data of 216 psychiatric outpatients was analyzed using structural equation modeling. The questionnaires included are Korean Anxiety Sensitivity Index-3, Korean version of the Distress Overtolerance Scale, Korean-Ruminative Response Scale, and Impact of Event Scale-Revised Korean Version. Results: ：Anxiety sensitivity and distress overtolerance positively predicted PTSS. Also, the mediating effects of brooding in the relationship between anxiety sensitivity and PTSS, and distress overtolerance and PTSSwere significant. Conversely, reflection did not significantly mediate the relationships between anxiety sensitivi-ty or distress overtolerance, and PTSS. Conclusions ：The results drawn from this study highlighted the differential roles of brooding and reflectionin the mediating role. Findings suggest the important role of brooding as a mechanism mediating the relationship between anxiety sensitivity and PTSS, as well as distress overtolerance and PTSS.

Purpose: Early intervention after trauma is needed for reduction in clinical distress and prevention of chronic posttraumatic stress disorder (PTSD). This study describes findings from an open pilot trial of a brief stabilization psychotherapy based on imagery techniques for adults with acute PTSD (i.e., within 3 months of onset). Materials and Methods: Four sessions of 60-minute individual psychotherapy were conducted on 18 participants with PTSD within 3 months after accidents, 15 of whom completed the treatment. The clinician-administered PTSD scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the Hamilton Depression and Anxiety Rating Scales, and self-questionnaires were administered at pre-treatment, post-treatment, and 6-month follow-up. Results: Eight (53.3%) of the 15 patients at post-treatment and 8 of the 9 patients at 6-month follow-up did not meet the DSM-5 criteria for PTSD. Reliable change of PTSD symptoms after treatment was observed in 6 of 15 (45.0%) patients at post-treatment and in 4 of 9 (45.0%) patients after 6 months. There was a significant decrease in PTSD, depression, anxiety, and impaired quality of life scores after treatment, and these gains were maintained after 6 months. No cases of exacerbated PTSD symptoms were observed among completers and non-completers. Conclusion Our findings suggest that brief stabilization sessions are safe treatment options for acute PTSD (KCT0001918).

Objectives: An accurate and easy-to-identify form is needed for the early evaluation of suicidal ideation in high-risk patients. Therefore, this study examined the validity and reliability of a Korean version of the Ultra-Short Suicidal Ideation Scale (K-USSIS). Methods: A total of 161 psychiatric university-affiliated general hospital patients completed the K-USSIS. The data were analyzed using correlation, internal consistency, and confirmatory factor analyses. Results: First, the scale had good internal consistency with a Cronbach’s α of 0.94. Second, the confirmatory factor analysis demonstrated that the single-factor model had a reasonable fit (comparative fit index=0.99, Tucker–Lewis index=0.98, standardized root mean squared residual=0.01, and root mean square error of approximation=0.10). Finally, the convergent validity analysis revealed a significant positive correlation with depression, anxiety, and hopelessness. Conclusion The findings suggest that the K-USSIS has good psychometric properties and can serve as a valuable tool for screening for suicidal ideation to ensure early intervention in Korean psychiatric patients.

Background: Although the field of psychology currently recommends trauma-focused cognitive behavioral therapy for early psychological intervention for acute traumatic stress, additional research is required for safe and efficient psychotherapy that can delivered to a broader population and within a brief period of time. Methods: This pilot study examined the safety and feasibility of a single-session group stabilization intervention for individuals conducted at an average of two weeks after various types of traumatic events. Further development of DSM-5 mental disorders, such as post-traumatic stress disorder (PTSD) and others, was assessed at the six-month follow-up. A total of 38 participants with acute stress symptoms participated in a single-session 90-minute group psychotherapy, which consists of psychoeducation; identification of and coping with triggers; somatosensory grounding; and containment exercise. Results: After six months, follow-up was conducted on 34 (89.5%) patients, who completed the Structured Clinical Interview for DSM-5 Mental Disorders and the PTSD Checklist-5. One (2.9%) participant met the current diagnosis of PTSD, whereas none met any other psychiatric diagnoses. A significant decrease was noted in PTSD scores between baseline and follow-up (t=7.4, df=33, p<0.001, Cohen’s d=1.27) measured using the PTSD Checklist-5. Conclusion The finding suggests that a single stabilization session can be used in a safe and efficient manner at of the acute stage of trauma.

Objectives: ：This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods: ：A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results: ：The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions ：Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient- doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.

Purpose: The benefits of early administration of androgen-deprivation therapy (ADT) in patients with prostate-specific antigen (PSA)-only recurrent prostate cancer (PCa) following radical prostatectomy (RP) are controversial. We investigated the impact of early versus delayed ADT on survival outcomes in patients with non-metastatic, localized or locally advanced PCa who received radiation therapy (RT) following RP and later developed distant metastasis. Materials and Methods: A retrospective analysis was performed on 69 patients with non-metastatic, localized or locally advanced PCa who received RT following RP and later developed distant metastasis between January 2006 and December 2012. Patients were stratified according to the level of PSA at which ADT was administered (<2 ng/mL vs. ≥2 ng/mL). Study endpoints were progression to castration-resistant prostate cancer (CRPC)-free survival and cancer-specific survival (CSS). Results: Patients were stratified according to the criteria of 2 ng/mL of PSA at which ADT was administered, based on the Youden sensitivity analysis. Delayed ADT at PSA ≥2 ng/mL was an independent prognosticator of cancer-specific mortality (p=0.047), and a marginally significant prognosticator of progression to CRPC (p=0.051). During the median follow-up of 81.0 (interquartile range 54.2–115.7) months, patients who received early ADT at PSA <2 ng/mL had significantly higher CSS rates compared to patients who received delayed ADT at PSA ≥2 ng/mL (p=0.002). Progression to CRPC-free survival was comparable between the two groups (p=0.331). Conclusion Early ADT at the PSA level of less than 2 ng/mL confers CSS benefits in patients with localized or locally advanced PCa who were previously treated with RP.

OBJECTIVES: The Illness Intrusiveness Rating Scale (IIRS) is a well-validated self-report instrument for assessing negative impact of chronic illness and/or adverse effects of its treatment on everyday life domains. Although extensive literature probed its psychometric properties in medical illness, little attention was paid for its validity for psychiatric population. This study aimed to test factorial structure of the Korean Version of the IIRS (IIRS-K) in a consecutive sample of psychiatric outpatients. METHODS: Data set of 307 first-visit patients of psychiatric clinic at Guri Hanyang univ. Hospital were used. Exploratory and confirmatory factor analysis, internal consistency were tested in IIRS-K. We also checked Spearman's correlation analysis between IIRS-K, Zung's self-report anxiety scale and Zung's self-report depression scale. RESULTS: 76.9% of the patients were with anxiety disorder and depressive disorder. The principal component factor analysis of the IIRS-K extracted three-factor structure accounted for 63.2% of total variance that was contextually similar to the original English version. This three-factor solution showed the best fit when tested confirmatory factor analysis compared to the original IIRS, two-factor model of IIRS-K suggested from medical outpatients, and one-factor solution. The IIRS-K also showed good internal consistency (Cronbach's α=0.90) and good convergent validity with anxiety and depression scales. CONCLUSIONS The IIRS-K showed the three-factor structure that was similar but not identical to original version. Overall, this study proved factorial validity of the IIRS-K and it can be used for Korean clinical population.

BACKGROUND: To further understand the relationship between anxiety and depression, this study examined the factor structure of the combined items from two validated measures for anxiety and depression. METHODS: The participants were 406 patients with mixed psychiatric diagnoses including anxiety and depressive disorders from a psychiatric outpatient unit at a university-affiliated medical center. Responses of the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI)-II, and Symptom Checklist-90-Revised (SCL-90-R) were analyzed. We conducted an exploratory factor analysis of 42 items from the BAI and BDI-II. Correlational analyses were performed between subscale scores of the SCL-90-R and factors derived from the factor analysis. Scores of individual items of the BAI and BDI-II were also compared between groups of anxiety disorder (n = 185) and depressive disorder (n = 123). RESULTS: Exploratory factor analysis revealed the following five factors explaining 56.2% of the total variance: somatic anxiety (factor 1), cognitive depression (factor 2), somatic depression (factor 3), subjective anxiety (factor 4), and autonomic anxiety (factor 5). The depression group had significantly higher scores for 12 items on the BDI while the anxiety group demonstrated higher scores for six items on the BAI. CONCLUSION: Our results suggest that anxiety and depressive symptoms as measured by the BAI and BDI-II can be empirically differentiated and that particularly items of the cognitive domain in depression and those of physical domain in anxiety are noteworthy.
Anxiety Disorders ; Anxiety* ; Depression* ; Depressive Disorder ; Diagnosis ; Factor Analysis, Statistical* ; Humans ; Outpatients*