1.Establishing Integrated Treatment Centers to Improve Mental Health Services: International Examples and Strategies for South Korea
Han-Sung LEE ; Hyunju LEE ; Yu Jin LEE ; Soon-Beom HONG ; Se Hyun KIM ; Hye Yoon PARK ; Soo-Hee CHOI ; Jee Eun PARK ; Sang Jin RHEE ; Juwon LEE ; Sukkyung LEE ; Jee Hoon SOHN ; Yong Min AHN
Journal of Korean Neuropsychiatric Association 2024;63(4):207-217
The global burden of mental illness has increased significantly since the COVID-19 pandemic. In South Korea, despite this rising burden, the utilization of mental health services remains critically low compared to other countries. This study evaluated successful integrated treatment centers from various countries, including the United States, the United Kingdom, and Australia, to identify the best practices that can be applied to South Korean society. These international examples informed the development of Mind the SHIM (SNUH Health in Mind) center, an integrated treatment model designed to address the gaps in non-pharmacological mental health services in South Korea. Mind the SHIM center focuses on developing and validating programs tailored to local needs, emphasizing professional education, systematic program delivery, and community collaboration. The biopsychosocial approach of the center is expected to enhance the overall quality of life of the patients and increase the utilization of mental health services, reducing the broader economic and social burden of mental illness in South Korea.
2.Establishing Integrated Treatment Centers to Improve Mental Health Services: International Examples and Strategies for South Korea
Han-Sung LEE ; Hyunju LEE ; Yu Jin LEE ; Soon-Beom HONG ; Se Hyun KIM ; Hye Yoon PARK ; Soo-Hee CHOI ; Jee Eun PARK ; Sang Jin RHEE ; Juwon LEE ; Sukkyung LEE ; Jee Hoon SOHN ; Yong Min AHN
Journal of Korean Neuropsychiatric Association 2024;63(4):207-217
The global burden of mental illness has increased significantly since the COVID-19 pandemic. In South Korea, despite this rising burden, the utilization of mental health services remains critically low compared to other countries. This study evaluated successful integrated treatment centers from various countries, including the United States, the United Kingdom, and Australia, to identify the best practices that can be applied to South Korean society. These international examples informed the development of Mind the SHIM (SNUH Health in Mind) center, an integrated treatment model designed to address the gaps in non-pharmacological mental health services in South Korea. Mind the SHIM center focuses on developing and validating programs tailored to local needs, emphasizing professional education, systematic program delivery, and community collaboration. The biopsychosocial approach of the center is expected to enhance the overall quality of life of the patients and increase the utilization of mental health services, reducing the broader economic and social burden of mental illness in South Korea.
3.Establishing Integrated Treatment Centers to Improve Mental Health Services: International Examples and Strategies for South Korea
Han-Sung LEE ; Hyunju LEE ; Yu Jin LEE ; Soon-Beom HONG ; Se Hyun KIM ; Hye Yoon PARK ; Soo-Hee CHOI ; Jee Eun PARK ; Sang Jin RHEE ; Juwon LEE ; Sukkyung LEE ; Jee Hoon SOHN ; Yong Min AHN
Journal of Korean Neuropsychiatric Association 2024;63(4):207-217
The global burden of mental illness has increased significantly since the COVID-19 pandemic. In South Korea, despite this rising burden, the utilization of mental health services remains critically low compared to other countries. This study evaluated successful integrated treatment centers from various countries, including the United States, the United Kingdom, and Australia, to identify the best practices that can be applied to South Korean society. These international examples informed the development of Mind the SHIM (SNUH Health in Mind) center, an integrated treatment model designed to address the gaps in non-pharmacological mental health services in South Korea. Mind the SHIM center focuses on developing and validating programs tailored to local needs, emphasizing professional education, systematic program delivery, and community collaboration. The biopsychosocial approach of the center is expected to enhance the overall quality of life of the patients and increase the utilization of mental health services, reducing the broader economic and social burden of mental illness in South Korea.
4.Establishing Integrated Treatment Centers to Improve Mental Health Services: International Examples and Strategies for South Korea
Han-Sung LEE ; Hyunju LEE ; Yu Jin LEE ; Soon-Beom HONG ; Se Hyun KIM ; Hye Yoon PARK ; Soo-Hee CHOI ; Jee Eun PARK ; Sang Jin RHEE ; Juwon LEE ; Sukkyung LEE ; Jee Hoon SOHN ; Yong Min AHN
Journal of Korean Neuropsychiatric Association 2024;63(4):207-217
The global burden of mental illness has increased significantly since the COVID-19 pandemic. In South Korea, despite this rising burden, the utilization of mental health services remains critically low compared to other countries. This study evaluated successful integrated treatment centers from various countries, including the United States, the United Kingdom, and Australia, to identify the best practices that can be applied to South Korean society. These international examples informed the development of Mind the SHIM (SNUH Health in Mind) center, an integrated treatment model designed to address the gaps in non-pharmacological mental health services in South Korea. Mind the SHIM center focuses on developing and validating programs tailored to local needs, emphasizing professional education, systematic program delivery, and community collaboration. The biopsychosocial approach of the center is expected to enhance the overall quality of life of the patients and increase the utilization of mental health services, reducing the broader economic and social burden of mental illness in South Korea.
5.Adequate Dose of Levothyroxine for Thyroid-Stimulating Hormone Suppression after Total Thyroidectomy in Patients with Differentiated Thyroid Cancer
Hyun Jin RYU ; Min Sun CHOI ; Hyunju PARK ; Tae Hyuk KIM ; Jae Hoon CHUNG ; So Young PARK ; Sun Wook KIM
Endocrinology and Metabolism 2024;39(4):615-621
Background:
The adequate dose of levothyroxine (LT4) for patients who have undergone total thyroidectomy (TT) for differentiated thyroid cancer (DTC) is uncertain. We evaluated the LT4 dose required to achieve mild thyroid-stimulating hormone (TSH) suppression in DTC patients after TT.
Methods:
The electronic medical records of patients who underwent TT for DTC and received mild TSH suppression therapy were reviewed. Linear regression analysis was performed to evaluate the association between LT4 dose (μg/kg) and an ordinal group divided by body mass index (BMI). We also evaluated the trend in LT4 doses among groups divided by BMI and age.
Results:
In total, 123 patients achieved mild TSH suppression (0.1 to 0.5 mIU/L). The BMI variable was divided into three categories: <23 kg/m2 (n=46), ≥23 and <25 kg/m2 (n=30), and ≥25 kg/m2 (n=47). In the linear regression analysis, BMI was negatively associated with the LT4 dose after adjusting for age and sex (P<0.001). The LT4 doses required to achieve mild TSH suppression based on the BMI categories were 1.86, 1.71, and 1.71 μg/kg, respectively (P for trend <0.001). Further analysis with groups divided by age and BMI revealed that a higher BMI was related to a lower LT4 dose, especially in younger patients aged 20 to 39 (P for trend=0.011).
Conclusion
The study results suggest an appropriate LT4 dose for mild TSH suppression after TT based on body weight in patients with DTC. Considering body weight, BMI, and age in estimating LT4 doses might help to achieve the target TSH level promptly.
6.Diagnostic Validity of the Comprehensive Attention Test in Patients With Attention-Deficit/Hyperactivity Disorder
Hyunju LEE ; Hannah HUH ; Woo Young KIM ; Eun Kyoung LEE ; Bum-Sung CHOI ; Bongseog KIM ; Hanik YOO
Journal of the Korean Academy of Child and Adolescent Psychiatry 2024;35(4):243-249
Objectives:
This study verified the diagnostic validity of the Comprehensive Attention Test (CAT) for attention-deficit/hyperactivity disorder (ADHD).
Methods:
A total of 336 participants were recruited in this study, including 168 patients with ADHD and 168 control group participants who were one-to-one matched for sex and age. We measured selective attention (visual and auditory), sustained attention, interferenceselective attention, divided attention, and working memory in the ADHD and control groups using the CAT. The sensitivity, specificity, positive predictive value, and negative predictive value of the CAT were calculated.
Results:
In this study, it was found that the sensitivity and specificity of the CAT were 0.879 and 0.846 in children, 0.855 and 0.838 in adolescents, and 0.800 and 0.733 in adults, respectively.
Conclusion
These results indicate that the CAT has a high diagnostic validity for ADHD from childhood to adulthood.
7.Comparisons of Genetic Architecture Using Polygenic Risk Scores Derived From Large-Scale Genome-Wide Association Study Data Between Patients With Schizophrenia, Bipolar Disorder and Healthy Controls
Dong Eun LEE ; Min Jun CHOI ; Eun Young CHO ; Yong Min AHN ; Hyunju LEE ; Woojae MYUNG ; Tae Hyon HA ; Sung-Wan KIM ; Heon-Jeong LEE ; Kyooseob HA ; Kyung Sue HONG ; Ji Hyun BAEK
Korean Journal of Schizophrenia Research 2024;27(2):57-62
Objectives:
In this study, we aimed to compare the genetic architecture of schizophrenia (SCZ) and bipolar disorder (BD) in a Korean population by analyzing polygenic risk scores (PRS) derived from large-scale psychiatric disorder genome-wide association study data, based on genetic information collected from SCZ, BD, and healthy control groups.
Methods:
The study included 713 Korean patients with SCZ, 1,317 with BD, 526 healthy controls. Genotyping was performed using the Korean Biobank Array. PRS-continuous shrinkage method was used to calculate the PRS. Analysis of covariance (ANCOVA) was conducted to determine the association between SCZ or BD disorder and PRS after adjusting for sex.
Results:
ANCOVA revealed significant differences in PRS values by diagnosis for PRS for SCZ (F=215.281, p<0.001), PRS for BD (F=13.811, p<0.001), and PRS for major depressive disorder (F=6.042, p=0.002). Post-hoc analysis showed that PRS for SCZ was highest in SCZ, followed by BD, and healthy controls. PRS for BD was elevated in both BD and SCZ compared to healthy controls.
Conclusion
Our study revealed quantitative differences in genetic architecture between SCZ and BD compared to healthy controls, while also suggesting a shared genetic background between the two disorders.
8.Etiology of Bacteremia in Children With Hemato-Oncologic Diseases From 2013 to 2023: A Single Center Study
Sun Woo PARK ; Ji Young PARK ; Hyoung Soo CHOI ; Hyunju LEE
Pediatric Infection & Vaccine 2024;31(1):46-54
Purpose:
This study aimed to identify the pathogens of bloodstream infection in children with underlying hemato-oncologic diseases, analyze susceptibility patterns, compare temporal trends with those of previous studies, and assess empirical antimicrobial therapy.
Methods:
Retrospective review study of children bacteremia in hemato-oncologic diseases was conducted at Seoul National University Bundang Hospital from January 2013 to July 2023.
Results:
Overall, 98 episodes of bacteremia were observed in 74 patients. Among pathogens isolated, 57.1% (n=56) were Gram-positive bacteria, 38.8% (n=38) were Gram-negative bacteria, and 4.1% (n=4) were Candida spp. The most common Gram-positive bacteria were coagulase-negative staphylococci (n=21, 21.4%) and Staphylococcus aureus, (n=14, 14.3%) whereas the most common Gram-negative bacteria were Klebsiella pneumoniae (n=16, 16.3%) and Escherichia coli (n=10, 10.2%). The susceptibility of Gram-positive bacteria to penicillin, oxacillin, and vancomycin was 11.5%, 32.7%, and 94.2%, respectively and the susceptibility of Gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin, and amikacin was 68.6%, 80%, 97.1%, 82.9%, and 91.4%, respectively. Methicillin-resistant S. aureus was detected in 1 strain and among Gram-negative strains, extended spectrum β-lactamase accounted for 28.9% (12/38). When analyzing the antibiotic susceptibility and empirical antibiotics, the mismatch rate was 25.5% (n=25). The mortality rate of children within 30 days of bacteremia was 7.1% (n=7).
Conclusions
Empirical antibiotic therapy for bacteremia in children with hemato-oncologic diseases should be based on the local antibiogram in each institution and continuous monitoring is necessary.
9.Pediatric Deaths Associated With Coronavirus Disease 2019 (COVID-19) in Korea
Eunjeong SHIN ; Young June CHOE ; Boyeong RYU ; Na-Young KIM ; Hyun Ju LEE ; Dong Hwi KIM ; Seong-Sun KIM ; Donghyok KWON ; Ki Wook YUN ; Su Eun PARK ; Eun Hwa CHOI ; Sangwon LEE ; Hyunju LEE
Journal of Korean Medical Science 2023;38(3):e21-
As of September 3, 2022, 5,388,338 coronavirus disease 2019 (COVID-19) cases and 46 deaths (3 in 2021 and 43 in 2022) were reported in children ≤ 18 years in Korea. Cumulative confirmed cases accounted for 67.3% of the population aged ≤ 18 years and case fatality rate was 0.85/100,000. Among 46 fatal cases, 58.7% were male and median age was 7 years.Underlying diseases were present in 47.8%; neurologic diseases (63.6%) and malignancy (13.6%) most common. Only four had history of COVID-19 immunization. COVID-19 associated deaths occurred at median 2 days from diagnosis (range: −1 to 21). Among COVID-19 deaths, 41.3% occurred before admission; 2 before hospital arrival and 17 in the emergency department. Among children whose cause was documented, myocarditis, respiratory and multiorgan failure were most common. COVID-19 associated death was seen early after diagnosis in children and public health policies to provide access to medical care for children with COVID-19 are essential during the pandemic.
10.Development of Lifestyle Scale for Psychiatric Patients with Metabolic Syndrome
Young-Wook CHOI ; Bo-Hyun YOON ; Hangoeunbi KANG ; Kyungmin KIM ; Yuran JEONG ; Hyunju YUN ; Jye-Heon SONG ; Young-Hwa SEA ; Suhee PARK ; Se-Won KANG
Mood and Emotion 2023;21(3):71-79
Background:
This study, examines the applicability of the Lifestyle Evaluation Tool for Patients with Metabolic Syndrome (LET-PMS) questionnaire, originally developed for general population, on psychiatric patients with metabolic syndrome.
Methods:
The study included 320 patients diagnosed with schizophrenia spectrum disorder (N=190), bipolar spectrum disorder (N=65), and depressive disorder (N=65). They were provided assignments using 36 items from the LETPMS questionnaire and various established scales. The evaluation encompassed psychometric properties of reliability, exploratory factor, and confirmatory factor analysis.
Results:
We refined the LET-PMS questionnaire by eliminating six items through a reliability test. The resultant questionnaire exhibited six factors. The overall Cronbach’s alpha value was 0.896, with factor-specific reliability coefficients ranging from 0.730 to 0.859. Based on confirmatory factor analysis of the adapted LET-PMS, the root mean square error of approximation was 0.069 (0.05-1.1). Goodness-of-fit and comparative fit indexes were 0.815 and 0.821, respectively. All 30 items met the criteria for suitable configuration.
Conclusion
The LET-PMS questionnaire demonstrated robust internal consistency and sound structural validity, making it suitable for psychiatric patients with metabolic syndrome.

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