The onset of many lifelong mental illnesses is during childhood and adolescence. There has been an increase in these conditions among children and adolescents especially, during the COVID-19 pandemic. It is essential to promote mental health literacy (MHL) as a preventive and universal intervention for children and adolescents. Positive mental health status in adolescence is related to an increased level of MHL, and various MHL programs at schools have been reported to be effective for adolescent students worldwide. Recently, MHL programs have been developed in South Korea to be used by schoolteachers. There is a need for active dissemination and development of future programs. For continuous and effective education, it is desirable to include MHL education in regular school curricula.

The coronavirus disease 2019 (COVID-19) pandemic is profoundly affecting human life around the world. While the mental health of patients and quarantined is of increasing concern, the general public’s mental health also requires significant attention. COVID-19 also has the potential to threaten the mental health of children and adolescents significantly. This paper reviews the effects of the pandemic on the mental health of the general public, including children and adolescents. The risk factors for mental health problems are also reviewed. South Korea has implemented preemptive and aggressive quarantine measures against COVID-19. Mental health professionals have performed various psychological services to support the general public immediately and actively. This paper presents those supporting measures and discusses their limitations. Recognizing the importance of the impact of the pandemic on the mental health of the general public, observing its direct and indirect consequences, and organizing a multi-disciplinary system based on empathy and collaboration are important for developing effective support measures. In particular, national policies and support are needed to implement them.

OBJECTIVE: Previous studies showing the association of exposure to peer (PeVA) and parental verbal abuse in childhood with structural alterations in the young adult brain suggest functional changes in adolescence. In this functional MRI study, we investigated the effects of exposure to PeVA, during elementary and middle school periods, on brain response to emotional words, in high school students. METHODS: An emotional Stroop task consisting of swear, negative, positive, and neutral words was performed during functional MRI scan for 23 subjects who were divided into low- and high exposure groups to PeVA. RESULTS: High-PeVA group had a higher depression score, greater left ventrolateral prefrontal cortex (VLPFC) activity, and higher left VLPFC-left hippocampus connectivity in swear word conditions. The VLPFC activity and left VLPFC-left hippocampus connectivity was negatively related to the severity of anxiety and depressive symptoms, respectively. CONCLUSION: These preliminary findings support the hypothesis that exposure to PeVA, during childhood, is an aversive stimulus associated with meaningful functional change in emotional regulation network, showing hypersensitivity to swear words, at middle adolescence.
Adolescent* ; Anxiety ; Brain ; Depression ; Hippocampus ; Humans ; Hypersensitivity ; Magnetic Resonance Imaging ; Parents ; Prefrontal Cortex* ; Young Adult

OBJECTIVE: The aim of the present study was to examine the psychometric properties of the Korean Verbal Abuse Questionnaire (K-VAQ) that consists of 15 items related with life-time verbal aggression exposure. METHODS: A total of 5814 university students who agreed to take part in the study completed the K-VAQ, the Korean version of the Life Event CheckList (LEC-K) and Impact of Event Scale-Revised (K-IES-R). Internal consistency was checked by using item-total item correlation and Cronbach's alpha coefficient. Exploratory and confirmatory factor analyses were performed, and convergent and concurrent validity levels were examined. Finally, a cluster analysis was conducted to verify the validity of the cutoff point of the K-VAQ. RESULTS: The Cronbach's alpha correlation coefficient was 0.9. The K-VAQ showed a single factor structure which explained 55.34% of the total variance. The K-VAQ was significantly associated with the LEC-K (r=0.24) and K-IES-R (r=0.28), indicating good convergent validity and concurrent validity. The cluster analysis provided four clusters of trauma experiences: high, moderate, low, and minimal, with K-VAQ ranges of 43-81, 20-42, 7-19, and 0-6, respectively. In a further investigation, a K-VAQ score of 40 was found to be the appropriate cutoff point to delineate the highly verbally abused group, as used in the previous studies. A sum of 36.5% of the highly verbally abused group reported to show substantial symptoms of PTSD (K-IES-R score >22). CONCLUSION: The present findings suggest that the K-VAQ has good psychometric properties for assessing verbal aggression among the Korean population.
Aggression ; Checklist ; Humans ; Psychometrics* ; Surveys and Questionnaires* ; Stress Disorders, Post-Traumatic

OBJECTIVES: Symptoms of attention-deficit hyperactivity disorder (ADHD) during childhood may persist into adulthood. This study included the development and validation process of the Korean Adult ADHD Rating Scale (K-AARS), which was developed for screening and monitoring treatment of adults with ADHD. METHODS: Preliminary questionnaires of the K-AARS were based on the reviews of previous adult ADHD scales and clinical experiences of the board certified child and adolescent psychiatrists in Korea. For this study, 136 adults (18-50 years old) with inattention, hyperactivity and/or impulsivity symptoms were enrolled as ADHD subjects, and compared with 406 control subjects (18-50 years old) without ADHD symptoms. Construct validity was examined using explorative factor analysis and Cronbach's alpha to obtain internal reliability coefficients. Concurrent validity was evaluated by comparison with the Conners' Adult ADHD Rating Scale (CAARS). RESULTS: An explorative factor analysis showed that the K-AARS had 8 factors (inattention, hyperactivity, impulsivity, antisocial personality disorder/conduct disorder/oppositional defiant disorder, impairment, driving, emotional dysregulation, disorganization). K-AARS was highly reliable in terms of internal consistency (Cronbach's alpha 0.77-0.95) and correlation between factors (0.57-0.86). Concurrent validity with the CAARS and discriminant validity were statistically significant. CONCLUSION: The K-AARS is a valid and reliable measure for assessment of Korean adults with ADHD.
Adolescent ; Adult* ; Antisocial Personality Disorder ; Child ; Factor Analysis, Statistical ; Humans ; Impulsive Behavior ; Korea ; Mass Screening ; Psychiatry ; Weights and Measures

OBJECTIVES: Abnormalities in various subcortical regions have been reported in previous structural neuroimaging studies for schizophrenia. To understand the subcortical abnormalities as a whole, all subcortical regions should be explored in each subject unlike most previous studies. Here, we explored major subcortical structures using volume measurement and shape analysis for schizophrenic patients (SZ), their unaffected siblings (Sib) and healthy controls without affected sibling (HC). METHODS: Structural magnetic resonance images were acquired from 24 SZ, 24 Sib and 19 HC. Both segmentation and shape analysis for subcortical structures was performed using FMRIB Integrated Registration and Segmentation Tool integrated within the FSL software. The group comparison of subcortical volumes was performed with multivariate analysis of variance (MANOVA). RESULTS: In SZ group, shape deformities were observed in the left nucleus caudates, left thalamus, left putamen and bilateral pallidus were increased compared with HC group. In Sib group, shape deformities were observed in the left pallidus, left putamen and left putamen was decreased compared with HC group. In Sib group, left nucleus accumbens was increased compared with SZ group. CONCLUSION: The result of this study using volume measurement and shape analysis suggest that subcortical structural abnormalities in cortico-striato-pallido-thalamic and reward circuits are related with both the pathology of schizophrenia and genetic predisposition.
Congenital Abnormalities ; Genetic Predisposition to Disease ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Multivariate Analysis ; Neuroimaging ; Nucleus Accumbens ; Putamen ; Reward ; Schizophrenia ; Siblings ; Thalamus

OBJECTIVES: Characteristic symptoms, including hyperactivity and easy distractibility, in children with attention-deficit hyperactivity disorder (ADHD) suggest that their brain status, even at rest, might differ from that of healthy children. This study was conducted in order to determine whether resting state brain activity is compromised in medication-naive children with ADHD. METHODS: Twenty medication-naive children with ADHD (mean age 10.3+/-2.5) and 28 age- and gender-matched healthy volunteers (mean age 10.3+/-2.0) underwent measurements for resting state brain activity using functional magnetic resonance imaging (fMRI). Among resting state related-independent components (RSICs) extracted from fMRI data using independent component analysis, a significant difference in RSICs was observed between groups, using a mixed Gaussian/gamma model. RESULTS: Except for IQ, which was higher in the healthy control group, no demographic difference was observed between the two groups (p<.001). Significantly less activation of one RSIC, which includes the bilateral precuneus/posterior cingulate cortex, occipito-temporal junction, and anterior cingulate cortex, was observed in the ADHD group, compared with the control group (p<.05). CONCLUSION: An abnormal RSIC, posterior default mode network (DMN), was observed in the medication-naive ADHD group. Results of our study suggest that abnormality of posterior DMN is one of the main pathophysiologies of ADHD.
Brain ; Child ; Gyrus Cinguli ; Humans ; Magnetic Resonance Imaging

OBJECTIVE: Resting-state networks (RSNs), including the default mode network (DMN), have been considered as markers of brain status such as consciousness, developmental change, and treatment effects. The consistency of functional connectivity among RSNs has not been fully explored, especially among resting-state-related independent components (RSICs). MATERIALS AND METHODS: This resting-state fMRI study addressed the consistency of functional connectivity among RSICs as well as their spatial consistency between 'at day 1' and 'after 4 weeks' in 13 healthy volunteers. RESULTS: We found that most RSICs, especially the DMN, are reproducible across time, whereas some RSICs were variable in either their spatial characteristics or their functional connectivity. Relatively low spatial consistency was found in the basal ganglia, a parietal region of left frontoparietal network, and the supplementary motor area. The functional connectivity between two independent components, the bilateral angular/supramarginal gyri/intraparietal lobule and bilateral middle temporal/occipital gyri, was decreased across time regardless of the correlation analysis method employed, (Pearson's or partial correlation). CONCLUSION: RSICs showing variable consistency are different between spatial characteristics and functional connectivity. To understand the brain as a dynamic network, we recommend further investigation of both changes in the activation of specific regions and the modulation of functional connectivity in the brain network.
Brain/*physiology ; Brain Mapping ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging/*methods ; Male ; Neural Pathways/*physiology ; Regression Analysis ; Rest/*physiology ; Young Adult

This review examined the treatment of attention-deficit/hyperactivity disorder (ADHD) in adults. It briefly addresses the issues about the cause of hospital visit, diagnosis, and impact of disease, specific to adults. The article focused on the evidence regarding the efficacy and tolerability of short- and long-acting stimulant medications, as well as the non-stimulant medications such as atomoxetine and bupropion in the treatment of the adult ADHD. Generally speaking, variability in diagnostic criteria, dosing parameters and response rates between the various studies were considerable. The aggregated literature shows that both the stimulants and non-stimulants had clinically significant beneficial effect on treating ADHD in adults. Special attention is given to the pharmacological treatment for patients with adult ADHD and various comorbidities. In summary, medications are effective and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.
Adult ; Bupropion ; Comorbidity ; Humans ; Propylamines ; Atomoxetine Hydrochloride

This review examined the treatment of attention-deficit/hyperactivity disorder (ADHD) in adults. It briefly addresses the issues about the cause of hospital visit, diagnosis, and impact of disease, specific to adults. The article focused on the evidence regarding the efficacy and tolerability of short- and long-acting stimulant medications, as well as the non-stimulant medications such as atomoxetine and bupropion in the treatment of the adult ADHD. Generally speaking, variability in diagnostic criteria, dosing parameters and response rates between the various studies were considerable. The aggregated literature shows that both the stimulants and non-stimulants had clinically significant beneficial effect on treating ADHD in adults. Special attention is given to the pharmacological treatment for patients with adult ADHD and various comorbidities. In summary, medications are effective and combined medication and psychosocial treatment is the most beneficial treatment option for most adult patients with ADHD.
Adult ; Bupropion ; Comorbidity ; Humans ; Propylamines ; Atomoxetine Hydrochloride