1.Psychological Inflexibility, Cognitive Fusion, and Thought–Action Fusion as a Transdiagnostic Construct: Direct Comparisons Among Major Depressive Disorder, Obsessive–Compulsive Disorder, and Healthy Controls
Sang Won LEE ; Seung Jae LEE ; Mina CHOI
Psychiatry Investigation 2025;22(1):93-101
Objective:
Evidence suggests that acceptance and commitment therapy (ACT) processes function as transdiagnostic factors in both major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) individually. However, few studies have directly compared these two clinical disorders. Therefore, this study aimed to identify potential transdiagnostic factors associated with ACT across MDD, OCD, and healthy control (HC) groups.
Methods:
A total of 34 MDD patients, 43 OCD patients, and 46 HCs were recruited through subway advertisements and outpatient services at a university hospital. Participants completed the Acceptance and Action Questionnaire-II, Cognitive Fusion Questionnaire, thought-action fusion (TAF) scale, and symptom severity scales.
Results:
Direct group comparisons revealed higher psychological inflexibility, cognitive fusion, and likelihood of TAF in the clinical groups compared to the HCs, with no differences between the MDD and OCD groups. These three transdiagnostic factors were variously correlated with both depressive and obsessive–compulsive (OC) symptoms in all groups. Regression analyses demonstrated that the three transdiagnostic factors accounted for 26% of the depressive symptoms in the MDD group (R2=0.26, p=0.028) and 27% of the OC symptoms in the OCD group (R2=0.27, p=0.014).
Conclusion
These findings from the direct group comparisons of the three groups confirmed that psychological inflexibility, cognitive fusion, and likelihood of TAF are potential transdiagnostic factors that moderately contribute to the primary symptoms of both MDD and OCD. From another perspective, these results also highlight the need to consider how ACT addresses disorder-specific variations beyond what is explained by these transdiagnostic factors in the future.
2.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.
3.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.
4.Ultrafast MRI for Pediatric Brain Assessment in Routine Clinical Practice
Hee Eun MOON ; Ji Young HA ; Jae Won CHOI ; Seung Hyun LEE ; Jae-Yeon HWANG ; Young Hun CHOI ; Jung-Eun CHEON ; Yeon Jin CHO
Korean Journal of Radiology 2025;26(1):75-87
Objective:
To assess the feasibility of ultrafast brain magnetic resonance imaging (MRI) in pediatric patients.
Materials and Methods:
We retrospectively reviewed 194 pediatric patients aged 0 to 19 years (median 10.2 years) who underwent both ultrafast and conventional brain MRI between May 2019 and August 2020. Ultrafast MRI sequences included T1 and T2-weighted images (T1WI and T2WI), fluid-attenuated inversion recovery (FLAIR), T2*-weighted image (T2*WI), and diffusion-weighted image (DWI). Qualitative image quality and lesion evaluations were conducted on 5-point Likert scales by two blinded radiologists, with quantitative assessment of lesion count and size on T1WI, T2WI, and FLAIR sequences for each protocol. Wilcoxon signed-rank tests and intraclass correlation coefficient (ICC) analyses were used for comparison.
Results:
The total scan times for equivalent image contrasts were 1 minute 44 seconds for ultrafast MRI and 15 minutes 30 seconds for conventional MRI. Overall, image quality was lower in ultrafast MRI than in conventional MRI, with mean quality scores ranging from 2.0 to 4.8 for ultrafast MRI and 4.8 to 5.0 for conventional MRI across sequences (P < 0.001 for T1WI, T2WI, FLAIR, and T2*WI for both readers; P = 0.018 [reader 1] and 0.031 [reader 2] for DWI). Lesion detection rates on ultrafast MRI relative to conventional MRI were as follows: T1WI, 97.1%; T2WI, 99.6%; FLAIR, 92.9%; T2*WI, 74.1%; and DWI, 100%. The ICC (95% confidence interval) for lesion size measurements between ultrafast and conventional MRI was as follows: T1WI, 0.998 (0.996–0.999); T2WI, 0.998 (0.997–0.999); and FLAIR, 0.99 (0.985–0.994).
Conclusion
Ultrafast MRI significantly reduces scan time and provides acceptable results, albeit with slightly lower image quality than conventional MRI, for evaluating intracranial abnormalities in pediatric patients.
5.Psychological Inflexibility, Cognitive Fusion, and Thought–Action Fusion as a Transdiagnostic Construct: Direct Comparisons Among Major Depressive Disorder, Obsessive–Compulsive Disorder, and Healthy Controls
Sang Won LEE ; Seung Jae LEE ; Mina CHOI
Psychiatry Investigation 2025;22(1):93-101
Objective:
Evidence suggests that acceptance and commitment therapy (ACT) processes function as transdiagnostic factors in both major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) individually. However, few studies have directly compared these two clinical disorders. Therefore, this study aimed to identify potential transdiagnostic factors associated with ACT across MDD, OCD, and healthy control (HC) groups.
Methods:
A total of 34 MDD patients, 43 OCD patients, and 46 HCs were recruited through subway advertisements and outpatient services at a university hospital. Participants completed the Acceptance and Action Questionnaire-II, Cognitive Fusion Questionnaire, thought-action fusion (TAF) scale, and symptom severity scales.
Results:
Direct group comparisons revealed higher psychological inflexibility, cognitive fusion, and likelihood of TAF in the clinical groups compared to the HCs, with no differences between the MDD and OCD groups. These three transdiagnostic factors were variously correlated with both depressive and obsessive–compulsive (OC) symptoms in all groups. Regression analyses demonstrated that the three transdiagnostic factors accounted for 26% of the depressive symptoms in the MDD group (R2=0.26, p=0.028) and 27% of the OC symptoms in the OCD group (R2=0.27, p=0.014).
Conclusion
These findings from the direct group comparisons of the three groups confirmed that psychological inflexibility, cognitive fusion, and likelihood of TAF are potential transdiagnostic factors that moderately contribute to the primary symptoms of both MDD and OCD. From another perspective, these results also highlight the need to consider how ACT addresses disorder-specific variations beyond what is explained by these transdiagnostic factors in the future.
6.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.
7.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.
8.Hepatocellular carcinoma in Korea: an analysis of the 2016-2018 Korean Nationwide Cancer Registry
Jihyun AN ; Young CHANG ; Gwang Hyeon CHOI ; Won SOHN ; Jeong Eun SONG ; Hyunjae SHIN ; Jae Hyun YOON ; Jun Sik YOON ; Hye Young JANG ; Eun Ju CHO ; Ji Won HAN ; Suk Kyun HONG ; Ju-Yeon CHO ; Kyu-Won JUNG ; Eun Hye PARK ; Eunyang KIM ; Bo Hyun KIM
Journal of Liver Cancer 2025;25(1):109-122
Background:
s/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and second leading cause of cancer-related deaths in South Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2016-2018.
Methods:
Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative database of patients newly diagnosed with HCC in South Korea, were analyzed. This study investigated 4,462 patients with HCC registered in the KPLCR in 2016-2018.
Results:
The median patient age was 63 years (interquartile range, 55-72). 79.7% of patients were male. Hepatitis B infection was the most common underlying liver disease (54.5%). The Barcelona Clinic Liver Cancer (BCLC) staging system classified patients as follows: stage 0 (14.9%), A (28.8%), B (7.5%), C (39.0%), and D (9.8%). The median overall survival was 3.72 years (95% confidence interval, 3.47-4.14), with 1-, 3-, and 5-year overall survival rates of 71.3%, 54.1%, and 44.3%, respectively. In 2016-2018, there was a significant shift toward BCLC stage 0-A and Child-Turcotte-Pugh liver function class A (P<0.05), although survival rates did not differ by diagnosis year. In the treatment group (n=4,389), the most common initial treatments were transarterial therapy (31.7%), surgical resection (24.9%), best supportive care (18.9%), and local ablation therapy (10.5%).
Conclusions
Between 2016 and 2018, HCC tended to be diagnosed at earlier stages, with better liver function in later years. However, since approximately half of the patients remained diagnosed at an advanced stage, more rigorous and optimized HCC screening strategies should be implemented.
9.Uncommon Pediatric Presentation:Cavernous Lymphangioma Afflicting the Scalp
Kyung-Ju LEE ; Lucia KIM ; Jae Won LEE ; Ji Won BYUN ; Jeonghyun SHIN ; Gwang Seong CHOI ; Hyun-Tae SHIN
Korean Journal of Dermatology 2025;63(1):15-18
Cavernous lymphangiomas, characterized by the cystic enlargement of lymphatic vessels in the dermis and subcutaneous tissue, are rarely reported in the scalp. We present the case of a 6-month-old male infant with occipital scalp swelling, whose ultrasonographic examination identified a multiseptated hypoechoic mass in the subcutaneous layer. Histologically, the tumor exhibited irregular, dilated spaces lined with a single layer of endothelial cells, showing D2-40 positivity. This represents a rare case of pediatric cavernous lymphangioma of the scalp, accompanied by a literature review.
10.Testing the reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index using Fitbit devices: a cross-sectional analysis
Si-Yeon LEE ; Ja-Eun CHOI ; Ji-Won LEE ; Yaeji LEE ; Jae-Min PARK ; Kyung-Won HONG
Korean Journal of Family Medicine 2025;46(1):42-47
Background:
Sleep disorders and insomnia are prevalent worldwide, with negative health outcomes. The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report assessment tool for evaluating sleep quality, comprising seven subdomains. The Korean version of the PSQI (PSQI-K) has been tested for reliability and validity in small sample sizes but lacks large-scale validation using objective measures.
Methods:
This study was conducted with 268 Korean adults attending health check programs. Participants completed the PSQI-K questionnaire and wore Fitbit devices (Fitbit Inc., USA) to ascertain sleep parameters. Reliability was analyzed using the Cronbach’s α coefficient, and construct validity was determined through factor analysis. Criteria validity was assessed by correlating their index scores with Fitbit sleep parameters. We identified the optimal cutoff for detecting sleep disorders.
Results:
The Cronbach’s α coefficient was 0.61, indicating adequate internal consistency. Factor analysis revealed three factors, explaining 48.2% of sleep quality variance. The index scores were negatively correlated with Fitbit sleep efficiency, total sleep time, and number of awakenings (P<0.05). The optimal cutoff point for identifying sleep disorder groups was ≥6.
Conclusion
The PSQI-K demonstrated good reliability and validity when correlated with Fitbit sleep parameters, offering a practical screening tool for identifying sleep disorders among Korean adults. Cutoff scores can help identify patients for sleep interventions. However, further large-scale studies are required to validate these findings.

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