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.

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.

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.

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.

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.

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.

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.

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.

Objectives: This study aimed to examine the relationship between three different impulsiveness traits and gambling preoccupation in a group of university students, and to investigate whether the gambling preoccupation can lead to impairment of important social areas through self-regulation failure. Methods: Five hundred eighty four university students completed the Korean version of the National Opinion Research Center DSM-IV Screen for Gambling Problems and the Barratt Impulsiveness Scale. The data of 553 students were finally analyzed. Impulsiveness traits were divided into three sub-scales: cognitive, motor, and non-planning impulsiveness. In order to verify our hypothesis, structural equation modeling was applied using AMOS software package, version 18.0. Results: Three different impulsiveness traits had no significant direct effect on gambling preoccupation (p>0.05). Gambling preoccupation had significant direct effects both on self-regulation failure and impairment of important social areas (p<0.05). Self-regulation failure had a significant mediating effect on the relationship between gambling preoccupation and impairment of significant relationships. Conclusions Our findings suggest that the gambling preoccupation cannot be directly explained by a personality trait related to impulsiveness. However, the gambling preoccupation can be a factor that causes impairment of important social areas, mediating self-regulation failure.

Objectives: Unawareness of hyponatremic risks associated with antidepressant use can lead to irreversible consequences, such as syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Numerous previous studies on antidepressant-induced hyponatremia have reported a significant correlation between hyponatremia and the initiation of antidepressants. Although selective serotonin reuptake inhibitors (SSRIs) are most associated with hyponatremia, there is no consensus regarding the relationship between different classes of antidepressants and hyponatremia. The aim of this study is to investigate the correlation between different classes of antidepressants and hyponatremia by analyzing reported incidence rates and odds ratios (ORs). Methods: This study reviewed literature available in both PubMed and Web of Knowledge using a combination of the search terms “antidepressants,” “hyponatremia,” “inappropriate ADH syndrome,” and “SSRI.” Results: This study included 42 cohort and case-control studies, and more than 100 case reports were reviewed individually. Due to differences in study designs, populations, and definitions of hyponatremia, the reported incidence rate of hyponatremia associated with antidepressant use varied widely, ranging from 0.01% to 40%. Among antidepressant classes, serotonin norepinephrine reuptake inhibitors (SNRIs) exhibited the highest incidence rate (70%). Mirtazapine and tricyclic antidepressants (TCAs) were reported to have a comparatively lower risk of hyponatremia. Specifically, the OR ranged from 1.18 to 4.8 for mirtazapine and from 1.2 to 3.3 for TCAs. Many studies have agreed that geriatric age and concurrent use of diuretics, such as thiazides, are probable risk factors for hyponatremia. Conclusions Although awareness of antidepressant-associated hyponatremia has increased among healthcare providers, including clinicians, there is still no consensus on the extent of risk posed by different classes of antidepressants. Based on the reviewed studies, SNRIs appear to carry a higher risk of hyponatremia compared to other classes of antidepressants.Therefore, clinicians may consider prescribing mirtazapine, which has a lower risk of hyponatremia, as an alternative to SNRIs for certain patient populations—particularly elderly patients and those taking diuretics such as thiazides.