1.Mind-Brain-Immune Interactions After Transplantation:A Psychoneuroimmunology-Informed Review
Journal of the Korean Society of Biological Therapies in Psychiatry 2026;32(1):14-25
Organ transplantation significantly improves survival and quality of life for patients with end-stage organ failure. However, the profound physical and psychological stress and immunological changes surrounding transplantation critically influence mental health and clinical outcomes. Psychoneuroimmunology, the interdisciplinary study of interactions among the central nervous, endocrine, and immune systems, offers an essential framework for understanding and addressing the psychological, social, and biological challenges faced by transplant recipients. This review synthesizes current evidence on the fundamental mechanisms of psychoneuroimmunology, post-transplant mental health issues, psychosocial impacts, and integrated clinical interventions, with particular attention to identity transformation, family and social relationships, cultural and economic factors, resilience, and social support. By linking these domains to psychoneuroimmunology mechanisms, we highlight the necessity of a biopsychosocial approach to optimize both mental health and immune stability in transplant care.
2.A Study of Factors Affecting Quality of Life in Korean Adults: Analysis Based on the Data From the 9th Korea National Health and Nutrition Examination Survey
Eun-Su CHO ; Young-Myo JAE ; Sae-Heon JANG ; Kyoung-Hwan LEE ; Kyoung-Beom KIM
Journal of the Korean Society of Biological Therapies in Psychiatry 2026;32(1):76-84
Objectives:
This study examined factors associated with health-related quality of life (HRQoL) in Korean adults.
Methods:
Using data from 5,620 participants in the 9th Korea National Health and Nutrition Examination Survey, obesity was defined as body mass index ≥25 kg/m2 and HRQoL assessed by the health-related quality of life instrument with 8 items (HINT-8). Complex survey weights were applied.
Results:
General linear and multiple regression analyses showed that among women, obesity was significantly associated with lower HINT-8 scores (B=-0.008, p=0.032), while no association was found in men. Age, household income, education, perceived stress, and smoking were also significantly related to HRQoL in both sexes.
Conclusions
HRQoL in Korean adults is influenced by obesity, socioeconomic status, and mental health indicators. The adverse effect of obesity observed only in women highlights the need for sex-specific public health strategies and the relevance of culturally adapted tools such as the HINT-8.
3.Impact of the COVID-19 Pandemic on Quality of Life:Differences Between Individuals With and Without Suicidal Ideation
Yun Woo AN ; Seung Bhin KIM ; Jong Hun LEE
Journal of the Korean Society of Biological Therapies in Psychiatry 2026;32(1):66-75
Objectives:
This study investigated whether the coronavirus disease 2019 (COVID-19) pandemic affected quality of life (QOL) and whether its impact differed between individuals with and without suicidal ideation.
Methods:
A secondary analysis was performed using community-based cross-sectional survey data collected in Daegu, Republic of Korea, in 2018 (pre-pandemic phase), 2020 (pandemic phase), and 2022 (post-peak phase). Participants aged 18 years or older were recruited through stratified random sampling. Suicidal ideation over the past year was assessed using a single “yeso” question. QOL was measured using the Korean version of the abbreviated version of the World Health Organization Quality of Life Assessment, comprising physical, psychological, social, and environmental domains. A multivariate analysis of covariance was conducted to examine the main and interaction effects of suicidal ideation and the COVID-19 phase, adjusting for age, education, marital status, and income.
Results:
Suicidal ideation was significantly associated with lower QOL in all domains (p<0.001). QOL declined significantly during the pandemic compared with the pre-pandemic phase, especially in the physical, psychological, and social domains. A significant interaction between suicidal ideation and the COVID-19 phase was observed for physical health (p=0.03), driven by a decline in physical QOL among those without suicidal ideation during the pandemic.
Conclusions
The COVID-19 pandemic negatively impacted multiple domains of QOL, with differing patterns depending on suicidal ideation status. Continuous and adaptive mental health strategies developed according to individuals’ suicidality are needed during and beyond public health crises to mitigate pandemic-related declines in QOL.
4.Attitude Toward Infection Prevention and Utilization of Local Mental Health Services During the COVID-19 Pandemic in Patient With Schizophrenia
Jun Yeong HEO ; Hyun Soo KIM ; Seong Hwan KIM
Journal of the Korean Society of Biological Therapies in Psychiatry 2026;32(1):52-65
Objectives:
This study aims to investigate the challenges faced by individuals with schizophrenia in adhering to COVID-19 prevention guidelines and the difficulties they experienced due to social distancing measures.
Methods:
The study focused on 286 registered members with schizophrenia who were utilizing mental health welfare center services in the Busan area. The general control group consisted of individuals aged 19 and older in Busan. A survey was used to examine changes in daily life due to COVID-19 and perceptions of preventive measures. The survey also investigated the difficulties in daily life and the services needed by individuals with schizophrenia after the onset of COVID-19.To compare the two groups, independent sample t-tests were used for continuous variables, and chi-square tests were conducted for categorical variables.
Results:
Compared to the general population, individuals with schizophrenia reported lower levels of anxiety about contracting COVID-19 and experiencing fatal outcomes. They also indicated that they were less likely to engage in new activities or experience conflicts with those around them. Additionally, they rated the necessity of COVID-19 preventive guidelines lower and reported experiencing less stress from adhering to these guidelines. However, individuals with schizophrenia expressed significant discomfort due to the reduction in face-to-face counseling as a result of the suspension of mental health welfare center services. They also reported difficulties with attending outpatient appointments and maintaining regular meals, among other challenges.
Conclusions
In this study, it was observed that individuals with schizophrenia tended to underestimate the risk and severity of COVID-19 infection and found it challenging to recognize the necessity of preventive measures. Additionally, they appeared to experience greater difficulties in managing their daily lives independently.
5.Facial Emotion Processing and Endophenotypic Traits in Euthymic Bipolar I Disorder and First-Degree Relatives
Jihyun CHO ; Kyungjae SEO ; Seunghee WON
Journal of the Korean Society of Biological Therapies in Psychiatry 2026;32(1):44-51
Objectives:
Patients with bipolar I disorder often show impairments in facial emotion recognition (FER), a key component of social cognition. This study used the Facial Labeling Task, which assesses the ability of Koreans to recognize emotions through facial expressions, to compare FER deficits among euthymic individuals with bipolar I disorder, their first-degree relatives, and healthy controls.
Methods:
Three groups participated in this study: euthymic bipolar I disorder patients (n=55), first-degree relatives (n=40), and healthy controls (n=52), matched for age, sex, and education. FER performance was assessed using eight standardized facial expressions (happiness, sadness, anger, fear, contempt, disgust, surprise, and neutral). Accuracy (commission error rate) and response times for each trial were recorded.
Results:
There were no significant group differences in demographic characteristics, psychopathology, or neurocognitive measures. FER accuracy did not differ significantly among the three groups. However, the bipolar I disorder group showed delayed response times for sadness (p<0.05) and neutral (p<0.05) expressions, and the first-degree relatives exhibited slower responses to fearful expressions (p<0.05) compared with healthy controls.
Conclusions
These findings suggest that patients with bipolar I disorder exhibit delayed processing of specific emotional expressions even during the euthymic state. Thus, FER impairments should be considered in the assessment and treatment of bipolar I disorder. However, FER deficits are less likely to represent an endophenotype of bipolar I disorder.
6.Behavioral and Psychological Symptoms and Instrumental Activities of Daily Living in Patients With Mild Cognitive Impairment
Il-Seon SHIN ; Min JHON ; Seon-Young KIM ; Hee-Young SHIN ; Ju-Yeon LEE ; Sung-Wan KIM ; Jae-Min KIM
Journal of the Korean Society of Biological Therapies in Psychiatry 2026;32(1):37-43
Objectives:
This study aimed to investigate the impact of behavioral and psychological symptoms (BPS), assessed by the neuropsychiatric inventory (NPI) total score, on instrumental activities of daily living (IADL) performance in patients with mild cognitive impairment.
Methods:
Ninety-two patients diagnosed with mild cognitive impairment who visited a university hospital dementia clinic were recruited. Assessments included the Korean version-Mini Mental State Examination, NPI, Korean-IADL (KIADL), and Short Form of Geriatric Depression Scale-Korean version. Correlation and hierarchical multiple regression analyses were performed to analyze the relationship between BPS and IADL.
Results:
The mean age of participants was 74.61±5.86 years. K-IADL scores significantly correlated with age (r=0.347, p<0.001) and NPI total score (r=0.265, p<0.05). Hierarchical regression analysis showed that the addition of the NPI total score significantly increased the explained variance of functional decline (R 2 =0.197, F=5.332, p<0.001), with age (β=0.354, p<0.001) and NPI total score (β=0.248, p<0.05) identified as independent predictors in patients with mild cognitive impairment.
Conclusions
The overall severity of BPS exerts a detrimental effect on IADL function in mild cognitive impairment patients, independent of age and cognitive status. These results underscore the clinical importance of evaluating the cumulative burden of BPS to predict functional prognosis and implement early interventions.
7.Psychosocial Factors Associated With Depressive Symptoms Among University Hospital Nurses
Seung-Gon KIM ; Eun Hyun SEO ; Young Joon AHN ; Hyung-Jun YOON
Journal of the Korean Society of Biological Therapies in Psychiatry 2026;32(1):26-36
Objectives:
This study aimed to investigate the prevalence of depressive symptoms among hospital nurses and their associations with psychosocial and job-related factors.
Methods:
A total of 515 nurses at one university hospital participated in this study. Data on demographics, job-related factors, burnout, social conflict, happiness, and ego-resiliency were collected using self-reported questionnaires. Depressive symptoms were assessed using the depressive subscale of the Hospital Anxiety and Depression Scale, with scores of 8 or higher indicating their presence. Demographics, job-related, and psychosocial factors were compared based on the presence of depressive symptoms. Logistic regression analysis was conducted to identify factors associated with depressive symptoms. In addition, the mediating effect of ego-resiliency on the relationship between burnout and depressive symptoms was examined.
Results:
A total of 226 participants (43.9%) were identified as having depressive symptoms. Happiness was associated with a lower risk of depressive symptoms, whereas burnout and social conflict were associated with a higher risk. Furthermore, ego-resiliency showed a significant mediating effect on the relationship between burnout and depressive symptoms. Being a basic or charge nurse; experiencing job dissatisfaction; being exposed to higher levels of burnout and social conflict; and having lower levels of happiness and ego-resiliency were significantly correlated with depressive symptoms.
Conclusions
Our findings suggest that intervention strategies aimed at enhancing happiness and ego-resiliency while reducing burnout and social conflict may help prevent and manage depressive symptoms among hospital nurses.
8.Neurobiological Mechanisms, Clinical Validity, and Real-World Implementation of Metaverse-Based Counseling for Adolescents through a School-Linked Mental Health Center
Sang Hyun BAEK ; Tae Young CHOI ; Jung Yeon MOON ; Hyang Hee JEONG ; Yun Kyong JEONG ; Se Jun PARK ; Jong Young EUN ; Eun Young JIN ; So Yeong YUK
Journal of the Korean Society of Biological Therapies in Psychiatry 2026;32(1):1-13
Metaverse-based mental health interventions have recently emerged as an extension of telepsychiatry, digital therapeutics (DTx), and virtual reality (VR)–based treatments for children and adolescents. The coronavirus disease 2019 pandemic accelerated the adoption of remote psychological assessment and intervention, raising critical questions regarding their clinical validity, developmental appropriateness, and long-term applicability in youth populations. Accumulating evidence has demonstrated that remote assessments and internet-based interventions can achieve clinical outcomes comparable to face-to-face approaches in selected domains, particularly anxiety, depression, and social communication difficulties. In parallel, immersive technologies such as VR and metaverse-based platforms have been applied to exposure-based interventions, social skills training, and emotion regulation in controlled and repeatable environments. This narrative review examined 48 empirical and review studies on telepsychiatry, internet-based cognitive behavioral therapy, DTx, VR, and metaverse-based interventions for children and adolescents. Neurobiological mechanisms relevant to fear extinction, executive function, emotion regulation, and social cognition were critically reviewed. In addition, real-world implementation experiences from a hospital-based Wee Center in Korea were integrated to evaluate feasibility within school-linked mental health services. The findings suggested that metaverse-based counseling should not be conceptualized as a stand-alone replacement for face-to-face treatment, but rather as a complementary, hybrid platform linking remote screening, structured digital intervention, and in-person clinical care. While current evidence supported feasibility and conditional clinical utility, further longitudinal, controlled, and cost-effectiveness studies were required to establish its role in pediatric mental health.
9.A Preliminary Study on the Effects of Transcutaneous Auricular Vagus Nerve Stimulation on Smoking Cessation and Related Psychological Factors
Hyunung LEE ; Seunghyun RYU ; Won-Pyo KIM ; Hyeonju RYU ; Eun Young KIM
Journal of the Korean Society of Biological Psychiatry 2025;32(1):9-16
Objectives:
Smoking causes 8 million deaths annually and significant socioeconomic burdens. Despite several therapies, cessation rates remain low due to nicotine’s addictive properties and withdrawal symptoms. This study evaluates the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) in reducing nicotine dependence and improving psychological states.
Methods:
This pilot study enrolled 23 adult smokers aged 19 to 65 years with the Fagerström Test for Nicotine Dependence (FTND) scores over 4 and daily cigarette consumption exceeding 10. Participants were randomized into treatment and control groups. The treatment group received personalized taVNS stimulation targeting the auricular branch of the vagus nerve, applied for 30 minutes, three times daily, for four weeks. The control group received a low-level fixed-current stimulation. Outcomes, including the FTND, cigarettes per day (CPD), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), and the Insomnia Severity Index (ISI), were assessed at baseline, 2 weeks, and 4 weeks. Statistical analyses included the Mann–Whitney U-test and Wilcoxon signed-rank test.
Results:
The treatment group showed significant reductions in the FTND (2.0 points at 2 weeks, p<0.05; 3.0 points at 4 weeks, p<0.05) and CPD (1.0 fewer cigarette at 2 weeks, p<0.05; 2.0 fewer cigarettes at 4 weeks, p<0.05). Additionally, the PHQ-9 scores decreased significantly in the treatment group (3.0 points at 2 weeks, p<0.05; no further improvement at 4 weeks). However, the GAD-7 and the ISI scores showed no statistically significant changes in either group. The control group exhibited slight improvements in the FTND and the CPD, possibly due to placebo effects or motivation induced by study participation.
Conclusions
This study highlights taVNS as a promising non-invasive treatment for smoking cessation, effective in reducing nicotine dependence and improving depressive symptoms. However, its effects on anxiety and sleep quality remain unclear. Larger studies are needed to confirm its efficacy and explore optimal parameters and underlying mechanisms.
10.Late Life Depression and Alzheimer’s Dementia
Journal of the Korean Society of Biological Psychiatry 2025;32(1):1-8
Late life depression (LLD) is common and characterized by specific cognitive decline, numerous comorbidies accompanied by consideration of polypharmacy, and heavy disability. Distinct structural and functional changes observed in neuroimaging lead to neurobehavioral symptoms in this population. Dysfunction of the default mode network, cognitive control network, anterior salience network, and positive valence system circuits brings about negative self-referential rumination, executive function problem, troubles in attention, and reward processing deficit. Due to frequent cognitive impairment in LLD and strong association between Alzheimer’s dementia (AD) and depressive symptoms, discrete elaboration is difficult. There are various linkages between LLD and AD in pathophysiologies including neuroinflammation, vascular disease, and neurodegeneration. These etiological hypotheses are supported by clinical manifestations, cognitive measurements, neuroimage and related molecular findings. Therefore, LLD is thought to be a risk factor for AD which should be managed. However, other perspectives on LLD suggest it as a prodromal manifestation of AD or as prognostic factor to predict disease progression. Consistent research with eligible criteria with homogenous diagnosis, cognitive and symptom measurement, and long-term follow-up studies would be needed to better understand the relationship between LLD and AD.

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