1.Diabetes Is Positively Associated With High Risk of Depression in Korean Cervical Cancer Patients: Korean National Health and Nutrition Examination Survey 2010–2021
Seon-Mi LEE ; Daun SHIN ; Aeran SEOL ; Sanghoon LEE ; Hyun-Woong CHO ; Kyung-Jin MIN ; Jin-Hwa HONG ; Jae-Kwan LEE ; Nak-Woo LEE ; Jae-Yun SONG ; Won Jun CHOI
Psychiatry Investigation 2025;22(1):57-65
Objective:
Objective of this study is to evaluate the association between high risk of depression and metabolic diseases such as hypertension, diabetes, and dyslipidemia in Korean cervical cancer patients.
Methods:
A total of 330 women with cervical cancer were included in this study, using data from the Korea National Health and Nutrition Examination Survey from 2010 to 2021. Participants were categorized into two groups—high risk of depression and non-depression—based on their answers to survey items related to depression. A multivariate logistic regression analysis was used to evaluate the influence of metabolic diseases on high risk of depression in patients with cervical cancer.
Results:
A total of 78 (23.64%) and 252 (76.36%) women were classified into the high risk of depression and non-depression groups, respectively. In multivariate logistic regression analysis adjusting for age, menopausal status, and smoking status, diabetes was associated with an odds ratio of 2.47 (95% confidence interval: 1.205, 5.071) for high risk of depression in cervical cancer patients. However, among the metabolic diseases, hypertension, and dyslipidemia were not associated with high risk of depression in patients with cervical cancer.
Conclusion
This study suggests that diabetes may be associated with a increased risk of high risk of depression in cervical cancer patients. Therefore, appropriate treatment of diabetes in cervical cancer patients may contribute to lowering the risk of depression in the future.
2.Sexual Victimization and Psychological and Behavioral Outcomes Among Children and Adolescents in South Korea
Hyun Ji LEE ; Jungtae CHOI ; Jae-Won KIM ; Kihyun KIM
Psychiatry Investigation 2025;22(5):564-573
Objective:
By focusing on a person-centered approach using latent class analyses (LCA), this study examined the patterns of sexual victimization among children and adolescents in South Korea and compared the psycho-behavioral outcomes of these classes.
Methods:
Participants were 546 females aged 6–17, including 117 sexual victimization survivors and 429 non-victims in South Korea. LCA, an analysis of covariance, and Bonferroni post-hoc tests were conducted. Psychological and behavioral outcomes were measured using the Korean version of the Child Behavior Checklist 6–18 and the Youth Self Report. Variables include internalizing (anxious/depressed, withdrawn/depressed, somatic complaints), externalizing (rule-breaking, aggressive behavior), social, thought, and attention problems.
Results:
Based on the fit statistics, proportion of each class, and interpretability, a three-class solution was selected as the best fitting model. Profile 1 mainly involved survivors of rape, which first occurred in adolescence through social relations involving alcohol, drugs, or filming. Profile 2 mainly comprised survivors of both rape and physical sexual harassment by close relations, such as family members or relatives, more than once. Profile 3 mainly comprised survivors of sexual harassment by strangers or social relations. Statistically significant differences were suggested in the psych-behavioral outcomes of the profiles compared with the non-victim group.
Conclusion
These findings highlight the importance of examining experiences of sexual violence in a multifaceted manner. This approach may provide more effective interventions for survivors and allow clinicians to gain an in-depth understanding of sexual victimization in children and adolescents while also increasing the understanding of potential psycho-behavioral consequences.
3.Observer-Blind Randomized Control Trial for the Effectiveness of Intensive Case Management in Seoul: Clinical and Quality-of-Life Outcomes for Severe Mental Illness
Hye-Young MIN ; Seung-Hee AHN ; Jeung Suk LIM ; Hwa Yeon SEO ; Sung Joon CHO ; Seung Yeon LEE ; Dohhee KIM ; Kihoon YOU ; Hyun Seo CHOI ; Su-Jin YANG ; Jee Eun PARK ; Bong Jin HAHM ; Hae Woo LEE ; Jee Hoon SOHN
Psychiatry Investigation 2025;22(5):513-521
Objective:
In South Korea, there is a significant gap in systematic, evidence-based research on intensive case management (ICM) for individuals with severe mental illness (SMI). This study aims to evaluate the effectiveness of ICM through a randomized controlled trial (RCT) comparing ICM with standard case management (non-ICM).
Methods:
An RCT was conducted to assess the effectiveness of Seoul-intensive case management (S-ICM) vs. non-ICM in individuals with SMI in Seoul. A total of 78 participants were randomly assigned to either the S-ICM group (n=41) or the control group (n=37). Various clinical assessments, including the Brief Psychiatric Rating Scale (BPRS), Montgomery–Åsberg Depression Rating Scale, Health of the Nation Outcome Scale, and Clinical Global Impression-Improvement (CGI-I), along with quality-of-life measures such as the WHO Disability Assessment Schedule, WHO Quality of Life scale, and Multidimensional Scale of Perceived Social Support (MSPSS) were evaluated over a 3-month period. Statistical analyses, including analysis of covariance and logistic regression, were used to determine the effectiveness of S-ICM.
Results:
The S-ICM group had significantly lower odds of self-harm or suicidal attempts compared to the control group (adjusted odds ratio [aOR]=0.30, 95% confidence interval [CI]: 0.21–1.38). Psychiatric symptoms measured by the BPRS and perceived social support measured by the MSPSS significantly improved in the S-ICM group. The S-ICM group also had significantly higher odds of CGI-I compared to the control group (aOR=8.20, 95% CI: 2.66–25.32).
Conclusion
This study provides inaugural evidence on the effectiveness of S-ICM services, supporting their standardization and potential nationwide expansion.
5.Development of automatic organ segmentation based on positron-emission tomography analysis system using Swin UNETR in breast cancer patients in Korea
Dong Hyeok CHOI ; Joonil HWANG ; Hai-Jeon YOON ; So Hyun AHN
The Ewha Medical Journal 2025;48(2):e30-
Purpose:
The standardized uptake value (SUV) is a key quantitative index in nuclear medicine imaging; however, variations in region‐of‐interest (ROI) determination exist across institutions. This study aims to standardize SUV evaluation by introducing a deep learning‐based quantitative analysis method that enhances diagnostic and prognostic accuracy.
Methods:
We used the Swin UNETR model to automatically segment key organs (breast, liver, spleen, and bone marrow) critical for breast cancer prognosis. Tumor segmentation was performed iteratively based on predefined SUV thresholds, and prognostic information was extracted from the liver, spleen, and bone marrow (reticuloendothelial system). The artificial intelligence training process employed 3 datasets: a test dataset (40 patients), a validation dataset (10 patients), and an independent test dataset (10 patients). To validate our approach, we compared the SUV values obtained using our method with those produced by commercial software.
Results:
In a dataset of 10 patients, our method achieved an auto‐segmentation accuracy of 0.9311 for all target organs. Comparison of maximum SUV and mean SUV values from our automated segmentation with those from traditional single‐ROI methods revealed differences of 0.19 and 0.16, respectively, demonstrating improved reliability and accuracy in whole‐organ SUV analysis.
Conclusion
This study successfully standardized SUV calculation in nuclear medicine imaging through deep learning‐based automated organ segmentation and SUV analysis, significantly enhancing accuracy in predicting breast cancer prognosis.
6.Environmental disease monitoring by regional Environmental Health Centers in Korea: a narrative review
Myung-Sook PARK ; Hwan-Cheol KIM ; Woo Jin KIM ; Yun-Chul HONG ; Won-Jun CHOI ; Seock-Yeon HWANG ; Jiho LEE ; Young-Seoub HONG ; Yong-Dae KIM ; Seong-Chul HONG ; Joo Hyun SUNG ; Inchul JEONG ; Kwan LEE ; Won-Ju PARK ; Hyun-Joo BAE ; Seong-Yong YOON ; Cheolmin LEE ; Kyoung Sook JEONG ; Sanghyuk BAE ; Jinhee CHOI ; Ho-Hyun KIM
The Ewha Medical Journal 2025;48(1):e3-
This study explores the development, roles, and key initiatives of the Regional Environmental Health Centers in Korea, detailing their evolution through four distinct phases and their impact on environmental health policy and local governance. It chronicles the establishment and transformation of these centers from their inception in May 2007, through four developmental stages. Originally named Environmental Disease Research Centers, they were subsequently renamed Environmental Health Centers following legislative changes. The analysis includes the expansion in the number of centers, the transfer of responsibilities to local governments, and the launch of significant projects such as the Korean Children’s Environmental Health Study (Ko-CHENS ). During the initial phase (May 2007–February 2009), the 10 centers concentrated on research-driven activities, shifting from a media-centered to a receptor-centered approach. In the second phase, prompted by the enactment of the Environmental Health Act, six additional centers were established, broadening their scope to address national environmental health issues. The third phase introduced Ko-CHENS, a 20-year national cohort project designed to influence environmental health policy by integrating research findings into policy frameworks. The fourth phase marked a decentralization of authority, empowering local governments and redefining the centers' roles to focus on regional environmental health challenges. The Regional Environmental Health Centers have significantly evolved and now play a crucial role in addressing local environmental health issues and supporting local government policies. Their capacity to adapt and respond to region-specific challenges is essential for the effective implementation of environmental health policies, reflecting geographical, socioeconomic, and demographic differences.
7.Prevalence and factors influencing postpartum depression and its culture-specific cutoffs for women in Asia: a scoping review
Bora MOON ; Hyun Kyoung KIM ; Ju-Hee NHO ; Hyunkyung CHOI ; ChaeWeon CHUNG ; Sook Jung KANG ; Ju Hee KIM ; Ju-Young LEE ; Sihyun PARK ; Gisoo SHIN ; Ju-Eun SONG ; Min Hee LEE ; Sue KIM
The Ewha Medical Journal 2025;48(1):e15-
The prevalence of postpartum depression (PPD) in Asia is reported to range from 13.53% to 22.31%. However, there remains a gap in the identification of PPD, particularly regarding cultural cutoff points. Therefore, the purpose of this scoping review was to determine the prevalence and associated factors of PPD in Eastern, South-eastern, Western, and Southern Asian countries and analyze the cutoff points of the Edinburgh Postnatal Depression Scale (EPDS) used across these countries. Following Arksey and O'Malley’s five-step scoping review framework, the population was defined as mothers, the concept as the EPDS, and the context as the Asian region. A literature search was conducted using PubMed, Embase, CINAHL, PsycINFO, and Web of Science. The data analysis focused on demographic characteristics, EPDS cutoffs and features, PPD prevalence, and its associated factors. Nineteen studies were selected. Most countries used translated versions of the EPDS with demonstrated reliability and validity. The cutoff scores varied, with most using scores of 10 or higher. The prevalence of PPD ranged from 5.1% to 78.7%. Key associated factors for PPD included cultural factors such as relationships with in-laws and preferences for the newborn’s sex. To improve the accuracy of PPD screening in Asia, the EPDS should be used consistently, and appropriate cutoff criteria must be established. In addition, prevention strategies and programs that reflect the cultural characteristics and social context of Asia need to be developed for the early detection and prevention of PPD.
8.Primary Cholangiocarcinoma of the Liver Presenting as a Complicated Hepatic Cyst: A Diagnostic Challenge
Chang Won HA ; Sang Deok SHIN ; Myung Ji GOH ; Byeong Geun SONG ; Wonseok KANG ; Dong Hyun SINN ; Geum-Youn GWAK ; Yong-Han PAIK ; Moon Seok CHOI ; Joon Hyeok LEE
The Korean Journal of Gastroenterology 2025;85(1):83-88
Primary cholangiocarcinoma is a rare bile duct epithelial neoplasm that can present with atypical clinical manifestations, complicating its diagnosis. A 62-year-old male showed symptoms suggestive of a complicated hepatic cyst that was later identified as intrahepatic cholangiocarcinoma. The patient presented with abdominal discomfort without fever. Imaging revealed a large cystic lesion in the liver. Despite the initial treatment for a presumed abscess, a biopsy confirmed cholangiocarcinoma. This case highlights the diagnostic challenge of distinguishing between benign complicated hepatic cysts and malignancies, particularly when typical markers of infection are absent. Early biopsy and vigilant assessments are crucial in such presentations to avoid a delayed diagnosis and initiate appropriate treatment.
9.Miliary Tuberculosis Initially Presenting as an Isolated Hepatic Abscess
Chang Won HA ; Sang Deok SHIN ; Myung Ji GOH ; Byeong Geun SONG ; Wonseok KANG ; Dong Hyun SINN ; Geum-Youn GWAK ; Yong-Han PAIK ; Moon Seok CHOI ; Joon Hyeok LEE
The Korean Journal of Gastroenterology 2025;85(1):78-82
Hepatic tuberculosis, typically associated with miliary tuberculosis, can occasionally present as localized liver lesions. This case report describes a 77-year-old male presenting with persistent abdominal pain and fever, following an endoscopic retrograde cholangiopancreatography for bile duct sludge removal. Subsequent computed tomography revealed focal liver lesions. Despite initial treatment with antibiotics for a suspected inflammatory liver abscess, his condition did not improve. A liver biopsy was performed, revealing caseous granulomas, and the tuberculosis polymerase chain reaction result was positive. The patient was diagnosed with primary hepatic tuberculosis, which later disseminated. Oral anti-tuberculosis therapy was initiated and is currently being closely monitored. This case emphasizes the importance of considering hepatic tuberculosis in the differential diagnosis of liver lesions, particularly in cases involving cholestatic liver function tests, and persistent symptoms unresponsive to conventional antibiotics.
10.Increased risk of dementia in patients with primary Sjogren’s syndrome: a nationwide population-based cohort study
Kyung-Ann LEE ; Hyeji JEON ; Hyun-Sook KIM ; Kyomin CHOI ; Gi Hyeon SEO
The Korean Journal of Internal Medicine 2025;40(2):330-338
Background/Aims:
This nationwide cohort study aimed to evaluate (1) whether primary Sjogren’s syndrome (pSS) can contribute to the development of dementia and (2) whether the use of hydroxychloroquine (HCQ) can decrease the incidence of dementia in patients with pSS using the Health Insurance Review and Assessment database.
Methods:
We established a cohort between 2008 and 2020 of 20,160 patients with pSS without a history of dementia. The control group comprised sex- and age-matched individuals with no history of autoimmune disease or dementia. Cox proportional hazard analyses were performed to identify the association between pSS and dementia development. We also assessed the hazard ratio (HR) of dementia in early users of HCQ (within 180 days of the diagnosis of pSS) compared to non-users, adjusted for age, sex, and comorbidities.
Results:
The incidence of dementia was 0.68 (95% CI 0.64–0.72) cases per 100 person-years in pSS, and it was 0.58 (0.56–0.60) in the controls. The adjusted HR (aHR) of developing dementia was 1.16 (1.09–1.25) times greater in the pSS group than in the controls. The risk of dementia did not increase in HCQ users (aHR 1.07 [0.94–1.21]), but HCQ non-users had a 1.22 (1.12–1.33) higher risk of developing dementia than the matched controls. The use of HCQ lowered the risk of dementia in comparison with non-users in patients with pSS (aHR 0.82 [0.71–0.94]).
Conclusions
Our results suggest that pSS is associated with an increased risk of dementia. HCQ may prevent dementia in patients with pSS.

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