Background: While there are many studies on adolescents’ suicide attempts in the western countries, studies on adolescent suicide in South Korea are relatively scarce. We compared demographical and clinical variables between the first and multiple suicide attempters and examined potential risk factors predicting multiple suicide attempts. Methods: Two hundred forty-eight suicide attempters aged from 11 to 19 years old who visited emergency department of Uijeongbu St. Mary’s Hospital, South Korea were recruited and divided into two groups: first attempter (n = 139, 56%) and multiple attempter (n = 109, 44%). A psychiatric interview with the Brief Emergency Room Suicide Risk Assessment were administered to all participants, and univariate analyses to compare characteristics of the two group and a multivariable logistic regression analysis to predict multiple suicidal attempts were performed. Results: Our results showed multiple suicide attempters were mostly female (78%), more severe in psychopathology (e.g., higher rate of psychiatric family history, diagnosis of axis I history, history of major depressive disorder, higher feeling of hopelessness/helplessness) and suicidality (e.g., repetitive/severe/continuous suicide ideation, lower regret for suicide attempt). Moreover, multiple suicide attempters were lower in psychiatric resources, such as lower personal achievement, lower ability to control emotion, and less insight. Multivariate logistic regression analysis showed that suicide ideation severity (odds ratio [OR], 2.30;P = 0.004), past history of axis I diagnosis (especially major depressive disorder; OR, 2.55; P = 0.002), and the use of “cutting” (OR, 2.85; P = 0.001) predicted multiple suicide attempts. Conclusion The present study suggests that multiple suicide attempters tend to have more severe clinical profiles than the first suicide attempters. Intervention for depression and selfmutilation behavior of suicide attempters may be important in preventing multiple suicide attempts of adolescents.

Background: While there are many studies on adolescents’ suicide attempts in the western countries, studies on adolescent suicide in South Korea are relatively scarce. We compared demographical and clinical variables between the first and multiple suicide attempters and examined potential risk factors predicting multiple suicide attempts. Methods: Two hundred forty-eight suicide attempters aged from 11 to 19 years old who visited emergency department of Uijeongbu St. Mary’s Hospital, South Korea were recruited and divided into two groups: first attempter (n = 139, 56%) and multiple attempter (n = 109, 44%). A psychiatric interview with the Brief Emergency Room Suicide Risk Assessment were administered to all participants, and univariate analyses to compare characteristics of the two group and a multivariable logistic regression analysis to predict multiple suicidal attempts were performed. Results: Our results showed multiple suicide attempters were mostly female (78%), more severe in psychopathology (e.g., higher rate of psychiatric family history, diagnosis of axis I history, history of major depressive disorder, higher feeling of hopelessness/helplessness) and suicidality (e.g., repetitive/severe/continuous suicide ideation, lower regret for suicide attempt). Moreover, multiple suicide attempters were lower in psychiatric resources, such as lower personal achievement, lower ability to control emotion, and less insight. Multivariate logistic regression analysis showed that suicide ideation severity (odds ratio [OR], 2.30;P = 0.004), past history of axis I diagnosis (especially major depressive disorder; OR, 2.55; P = 0.002), and the use of “cutting” (OR, 2.85; P = 0.001) predicted multiple suicide attempts. Conclusion The present study suggests that multiple suicide attempters tend to have more severe clinical profiles than the first suicide attempters. Intervention for depression and selfmutilation behavior of suicide attempters may be important in preventing multiple suicide attempts of adolescents.

Background: While there are many studies on adolescents’ suicide attempts in the western countries, studies on adolescent suicide in South Korea are relatively scarce. We compared demographical and clinical variables between the first and multiple suicide attempters and examined potential risk factors predicting multiple suicide attempts. Methods: Two hundred forty-eight suicide attempters aged from 11 to 19 years old who visited emergency department of Uijeongbu St. Mary’s Hospital, South Korea were recruited and divided into two groups: first attempter (n = 139, 56%) and multiple attempter (n = 109, 44%). A psychiatric interview with the Brief Emergency Room Suicide Risk Assessment were administered to all participants, and univariate analyses to compare characteristics of the two group and a multivariable logistic regression analysis to predict multiple suicidal attempts were performed. Results: Our results showed multiple suicide attempters were mostly female (78%), more severe in psychopathology (e.g., higher rate of psychiatric family history, diagnosis of axis I history, history of major depressive disorder, higher feeling of hopelessness/helplessness) and suicidality (e.g., repetitive/severe/continuous suicide ideation, lower regret for suicide attempt). Moreover, multiple suicide attempters were lower in psychiatric resources, such as lower personal achievement, lower ability to control emotion, and less insight. Multivariate logistic regression analysis showed that suicide ideation severity (odds ratio [OR], 2.30;P = 0.004), past history of axis I diagnosis (especially major depressive disorder; OR, 2.55; P = 0.002), and the use of “cutting” (OR, 2.85; P = 0.001) predicted multiple suicide attempts. Conclusion The present study suggests that multiple suicide attempters tend to have more severe clinical profiles than the first suicide attempters. Intervention for depression and selfmutilation behavior of suicide attempters may be important in preventing multiple suicide attempts of adolescents.

Background: While there are many studies on adolescents’ suicide attempts in the western countries, studies on adolescent suicide in South Korea are relatively scarce. We compared demographical and clinical variables between the first and multiple suicide attempters and examined potential risk factors predicting multiple suicide attempts. Methods: Two hundred forty-eight suicide attempters aged from 11 to 19 years old who visited emergency department of Uijeongbu St. Mary’s Hospital, South Korea were recruited and divided into two groups: first attempter (n = 139, 56%) and multiple attempter (n = 109, 44%). A psychiatric interview with the Brief Emergency Room Suicide Risk Assessment were administered to all participants, and univariate analyses to compare characteristics of the two group and a multivariable logistic regression analysis to predict multiple suicidal attempts were performed. Results: Our results showed multiple suicide attempters were mostly female (78%), more severe in psychopathology (e.g., higher rate of psychiatric family history, diagnosis of axis I history, history of major depressive disorder, higher feeling of hopelessness/helplessness) and suicidality (e.g., repetitive/severe/continuous suicide ideation, lower regret for suicide attempt). Moreover, multiple suicide attempters were lower in psychiatric resources, such as lower personal achievement, lower ability to control emotion, and less insight. Multivariate logistic regression analysis showed that suicide ideation severity (odds ratio [OR], 2.30;P = 0.004), past history of axis I diagnosis (especially major depressive disorder; OR, 2.55; P = 0.002), and the use of “cutting” (OR, 2.85; P = 0.001) predicted multiple suicide attempts. Conclusion The present study suggests that multiple suicide attempters tend to have more severe clinical profiles than the first suicide attempters. Intervention for depression and selfmutilation behavior of suicide attempters may be important in preventing multiple suicide attempts of adolescents.

Background: The healthcare workers (HCWs) were exposed to never-experienced psychological distress during the early stage of the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to investigate how the COVID-19 pandemic affected the mental health of HCWs during the hospital lockdown period due to mass healthcare-associated infection during the early spread of COVID-19. Methods: A real-time online survey was conducted between April 14–18, 2020 among HCWs who worked at the university hospital where COVID-19 was confirmed in a patient, and the hospital was shut down for 3 weeks. Along with demographic variables and work-related information, psychological distress was measured using the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), the Maslach Burnout Inventory-General Survey scale, and the Stress and Anxiety to Viral Epidemics-9. Results: The HCWs working in the cohort ward and those who have experienced social discrimination had significantly higher level of depression (PHQ-9 score; 5.24 ± 4.48 vs. 4.15 ± 4.38; P < 0.01 and 5.89 ± 4.78 vs. 3.25 ± 3.77; P < 0.001, respectively) and anxiety (GAD-7 score; 3.69 ± 3.68 vs. 2.87 ± 3.73;P < 0.05 and 4.20 ± 4.22 vs. 2.17 ± 3.06; P < 0.001, respectively) compared to other HCWs. Worries regarding the peer relationship and the skepticism about job were associated with depression (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.07–1.79; P < 0.05 and OR, 1.69; 95% CI, 1.31–2.17; P < 0.001, respectively) and anxiety (OR, 1.73; 95% CI, 1.21–2.49; P < 0.01 and OR, 1.54; 95% CI, 1.09–2.17; P < 0.05, respectively), while fear of infection or worsening of health was not. Path analysis showed that work-related stress associated with the viral epidemic rather than anxiety about the viral epidemic mainly contributed to depression. Conclusion The present observational study indicates that mental health problems of HCWs exposed to COVID-19 are associated with distress in work and social relationship. Early intervention programs focusing on these factors are necessary.

Objective: This study examined the diagnostic validity of a three-item ultra-brief screening tool for online gaming disorder in line with the gaming disorder criteria in the International Classification of Diseases 11th Revision. Methods: The Three-item Gaming disorder Test-Online-Centered (TIGTOC) was composed of three items using a four-point Likert scale selected from the Internet Game Use-Elicited Symptom Screen (IGUESS). Among a cohort of 2319 young-adolescent Internet users, the baseline data of 228 healthy controls and 45 Internet-gaming-disorder cases were analyzed. Receiver operation characteristic (ROC) analysis was performed using mental health specialists’ diagnoses as the gold standard. Results: The ROC curve analysis showed an area under the curve of 86%. Using a cut-off score of 4 from a full range of 0–9, the sensitivity, specificity, and Cronbach’s α were 72%, 90%, and 0.811, respectively. TIGTOC scores was positively associated with time spent on online gaming, depressive symptoms, attention-deficit/hyperactivity disorder symptoms, and addictive Internet use. Conclusion The TIGTOC appears to be a brief, valid, and reliable screening tool for online gaming disorder within the community or in primary care settings.

BACKGROUND: The objective of this study was to evaluate the changes in gene expression after incubation of cells with proteins released from different silk mat layers. METHODS: A silk cocoon from Bombyx mori was separated into four layers of equal thickness. The layers were numbered from 1 to 4 (from the inner to the outer layer). The proteins were released by sonication of a silk mat layer in normal saline. The concentration of proteins was determined by spectrophotometry. They were incubated with RAW264.7 cells, and changes in the expression of genes were evaluated by cDNA microarray analysis and quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). RESULTS: Layer 1 and 4 groups had higher protein concentrations compared to those in layer 2 and 3 groups. The genes associated with inflammation and angiogenesis showed significantly higher expression in layer 1 and 4 groups. The results of qRT-PCR were in agreement with those of the cDNA microarray analysis. CONCLUSIONS: The silk mat from the middle portion of the silkworm cocoon yielded a lower protein release and caused an insignificant change in the expression of genes that are associated with inflammation and angiogenesis.
Angiogenesis Inducing Agents ; Bombyx ; Gene Expression ; Inflammation ; Macrophages ; Oligonucleotide Array Sequence Analysis ; Silk ; Sonication ; Spectrophotometry

OBJECTIVE: To explore the structure of Internet gaming disorder (IGD) criteria and their distribution according to the different severity level of IGD. The associations of psychiatric comorbidities to each IGD symptom and to the IGD severity were also investigated. METHODS: Consecutively recruited 330 Korean middle school students underwent face-to-face diagnostic interviews to assess their gaming problems by clinicians. The psychiatric comorbidities were also evaluated with a semi-structured instrument. The data was analyzed using principal components analysis and the distribution of criteria among different severity groups was visualized by plotting univariate curves. RESULTS: Two principal components of ‘Compulsivity’ and ‘Tolerance’ were extracted. ‘Decrease in other activities’ and ‘Jeopardizing relationship/career’ may indicate a higher severity of IGD. While ‘Craving’ deserved more recognition in clinical utility, ‘Tolerance’ did not demonstrate much difference in distribution by the IGD severity. Internalizing and externalizing psychiatric disorders differed in distribution by the IGD severity. CONCLUSION: A hierarchic presentation of IGD criteria was revealed. ‘Decrease in other activities’ and ‘Jeopardizing relationship/career’ may represent a higher severity, thus indicating more clinical attention to such symptoms. However, ‘Tolerance’ was not found to be a valid diagnostic criterion.
Comorbidity ; Humans ; Immunoglobulin D ; Internet* ; Pathology*

OBJECTIVE: To explore the effect of vascular risk factors to the depressive symptom in Alzheimer's disease (AD). METHODS: Retrospective chart reviews were performed for the patients, who underwent comprehensive neuropsychiatric assessment in the geriatric psychiatric clinic in the period between May of 2015 and January of 2017. Patients with moderate to severe stage of AD, neurological comorbidities and major psychiatric disorders were excluded to minimize the confounding factors. Sixty five newly diagnosed early AD patients were included and bisected by the cutoff point of 5 in the short version of the Geriatric Depression Scale. Comparisons were done between two groups for vascular risk factors and other relevant clinic-demographic variables. Binary logistic regression analysis was additionally performed to estimate the effect of hypertension to the depressive symptoms. RESULTS: Among the investigated vascular risk factors, hypertension was associated with depressive symptom in the early AD patients. In the logistic regression, odd ratio of hypertension for depression was 4.34 (95% confidence interval 1.47-12.79). CONCLUSION: Depressive symptoms in the AD patients were associated with hypertension. Therefore, managing this vascular factor in the middle age may not only decrease the risk for neurovascular disorders, but also provide additional benefits in curtailing depression in AD.
Alzheimer Disease* ; Comorbidity ; Depression* ; Humans ; Hypertension* ; Logistic Models ; Middle Aged ; Neurocognitive Disorders ; Retrospective Studies ; Risk Factors

BACKGROUND: Psoriasis is an immune-mediated, chronic inflammatory disease affecting multiple aspects of patients' lives. Its epidemiology varies regionally; however, nationwide epidemiologic data on psoriasis depicting profile of Korean patients has not been available to date. OBJECTIVE: To understand nationwide epidemiologic characteristics and clinical features of adult patients with psoriasis visited university hospitals in Korea. METHODS: This multicenter, non-interventional, cross-sectional study recruited 1,278 adult patients with psoriasis across 25 centers in Korea in 2013. Various clinical data including PASI, BSA, DLQI, SF-36 and PASE were collected. RESULTS: A total of 1,260 patients completed the study (male:female=1.47:1). The mean age was 47.0 years with a distribution mostly in the 50s (24.9%). Early onset (<40 years) of psoriasis accounted for 53.9% of patients. The mean disease duration was 109.2 months; mean body mass index was 23.9 kg/m²; and 12.7% of patients had a family history of psoriasis. Plaque and guttate types of psoriasis accounted for 85.8% and 8.4%, respectively. Patients with PASI ≥10 accounted for 24.9%; patients with body surface area ≥10 were 45.9%. Patients with DLQI ≥6 accounted for 78.8%. Between PASI <10 and PASI ≥10 groups, significant difference was noted in age at diagnosis, disease duration, blood pressure, waist circumference of female, and treatment experiences with phototherapy, systemic agents, and biologics. CONCLUSION: This was the first nationwide epidemiologic study of patients with psoriasis in Korea and provides an overview of the epidemiologic characteristics and clinical profiles of this patient population.
Adult ; Biological Products ; Blood Pressure ; Body Mass Index ; Body Surface Area ; Cross-Sectional Studies* ; Diagnosis ; Epidemiologic Studies ; Epidemiology ; Female ; Hospitals, University ; Humans ; Korea* ; Phototherapy ; Psoriasis* ; Waist Circumference