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.

Objective: This study examined whether baseline levels of 14 serum biomarkers predicted antidepressant remission differently by sex at 12 weeks and 12 months. Methods: In a prospective cohort, 1,086 outpatients with depressive disorders received stepwise antidepressant treatment following a naturalistic protocol. Baseline serum samples were analyzed for biomarkers from six systems: immune (high-sensitivity C-reactive protein, tumor necrosis factor-alpha, interleukin-1 beta, interleukin-6, interleukin-4, interleukin-10), metabolic (leptin, ghrelin, total cholesterol), neurotrophic (brain-derived neurotrophic factor), neurotransmitter (serotonin), endocrine (cortisol), and nutritional (folate, homocysteine). Remission, defined as a Hamilton Depression Rating Scale scores ≤ 7, was assessed at 12 weeks and 12 months. Logistic regression models with biomarker-by-sex interaction and stratified analyses were used, adjusting for clinical covariates. Results: Higher baseline serotonin predicted 12-week remission in males but not in females. At 12 months, lower leptin and higher folate predicted remission only in males, while lower cortisol predicted remission only in females. These showed significant biomarker-sex interactions. No sex-specific interactions were found for immune markers. Conclusion Baseline serum biomarkers across biological systems showed sex-specific associations with treatment outcomes. Neurotransmitter, metabolic, endocrine, and nutritional markers may offer predictive value for sex-tailored, biomarker-informed treatment strategies in depression.

Background: This study evaluated the practicability of the suicide rate reduction target set by the current national suicide prevention policy in Korea, the fifth Master Plan for Suicide Prevention (2023–2027). This policy aims to lower the suicide rate from 26/100,000 in 2021 to 18.2/100,000 by 2027. Methods: We utilized monthly suicide statistics data from 2011 onwards. Using Bayesian regression and Autoregressive Integrated Moving Average (ARIMA) models, we conducted interrupted time series analyses to estimate the effect of the previous policy, the National Action Plan for Suicide Prevention (2018–2022), on suicide rates. We assumed this as the additional suicide reduction expected from the current policy. We generated point predictions and simulations for suicide rates from 2023 to 2027 using Bayesian regression and ARIMA models. Results: The interrupted time series analyses did not reveal a significant reduction in suicides attributable to the previous policy. Point predictions from the two models indicated that the suicide rate would remain approximately 24/100,000 in 2027. Almost all of the simulations of the 2027 suicide rate did not meet the policy target of 18.2/100,000. Conclusion The findings suggest that the Korean government’s suicide rate reduction target for 2027 is likely unattainable based on current trends and the limited effectiveness of previous policies. The objectives of suicide prevention policies should be evidence-based, attainable, and accountable.

Background: This study evaluated the practicability of the suicide rate reduction target set by the current national suicide prevention policy in Korea, the fifth Master Plan for Suicide Prevention (2023–2027). This policy aims to lower the suicide rate from 26/100,000 in 2021 to 18.2/100,000 by 2027. Methods: We utilized monthly suicide statistics data from 2011 onwards. Using Bayesian regression and Autoregressive Integrated Moving Average (ARIMA) models, we conducted interrupted time series analyses to estimate the effect of the previous policy, the National Action Plan for Suicide Prevention (2018–2022), on suicide rates. We assumed this as the additional suicide reduction expected from the current policy. We generated point predictions and simulations for suicide rates from 2023 to 2027 using Bayesian regression and ARIMA models. Results: The interrupted time series analyses did not reveal a significant reduction in suicides attributable to the previous policy. Point predictions from the two models indicated that the suicide rate would remain approximately 24/100,000 in 2027. Almost all of the simulations of the 2027 suicide rate did not meet the policy target of 18.2/100,000. Conclusion The findings suggest that the Korean government’s suicide rate reduction target for 2027 is likely unattainable based on current trends and the limited effectiveness of previous policies. The objectives of suicide prevention policies should be evidence-based, attainable, and accountable.

Background: This study evaluated the practicability of the suicide rate reduction target set by the current national suicide prevention policy in Korea, the fifth Master Plan for Suicide Prevention (2023–2027). This policy aims to lower the suicide rate from 26/100,000 in 2021 to 18.2/100,000 by 2027. Methods: We utilized monthly suicide statistics data from 2011 onwards. Using Bayesian regression and Autoregressive Integrated Moving Average (ARIMA) models, we conducted interrupted time series analyses to estimate the effect of the previous policy, the National Action Plan for Suicide Prevention (2018–2022), on suicide rates. We assumed this as the additional suicide reduction expected from the current policy. We generated point predictions and simulations for suicide rates from 2023 to 2027 using Bayesian regression and ARIMA models. Results: The interrupted time series analyses did not reveal a significant reduction in suicides attributable to the previous policy. Point predictions from the two models indicated that the suicide rate would remain approximately 24/100,000 in 2027. Almost all of the simulations of the 2027 suicide rate did not meet the policy target of 18.2/100,000. Conclusion The findings suggest that the Korean government’s suicide rate reduction target for 2027 is likely unattainable based on current trends and the limited effectiveness of previous policies. The objectives of suicide prevention policies should be evidence-based, attainable, and accountable.

Background: This study evaluated the practicability of the suicide rate reduction target set by the current national suicide prevention policy in Korea, the fifth Master Plan for Suicide Prevention (2023–2027). This policy aims to lower the suicide rate from 26/100,000 in 2021 to 18.2/100,000 by 2027. Methods: We utilized monthly suicide statistics data from 2011 onwards. Using Bayesian regression and Autoregressive Integrated Moving Average (ARIMA) models, we conducted interrupted time series analyses to estimate the effect of the previous policy, the National Action Plan for Suicide Prevention (2018–2022), on suicide rates. We assumed this as the additional suicide reduction expected from the current policy. We generated point predictions and simulations for suicide rates from 2023 to 2027 using Bayesian regression and ARIMA models. Results: The interrupted time series analyses did not reveal a significant reduction in suicides attributable to the previous policy. Point predictions from the two models indicated that the suicide rate would remain approximately 24/100,000 in 2027. Almost all of the simulations of the 2027 suicide rate did not meet the policy target of 18.2/100,000. Conclusion The findings suggest that the Korean government’s suicide rate reduction target for 2027 is likely unattainable based on current trends and the limited effectiveness of previous policies. The objectives of suicide prevention policies should be evidence-based, attainable, and accountable.

Objective: This study aimed to explore treatment outcomes and pharmacological treatment intensities across major depressive disorder (MDD) subtypes over a 24-month period in a naturalistic clinical setting. Methods: A total of 1,079 MDD patients were classified into melancholic (n = 182; 16.9%), atypical (n = 68; 6.3%), and unspecified (n = 829; 76.8%) subtypes and followed in a longitudinal cohort study. Treatment intensity and outcomes, including 12-week and 12-month remission and 24-month relapse rates, were measured using the Hamilton Depression Rating Scale. Results: There were no significant differences in remission or relapse rates across subtypes at 12 weeks, 12 months, or 24 months. However, melancholic and atypical subtypes received more intensive pharmacological treatments compared to the unspecified subtype, particularly during the initial 12-week treatment phase. This increased treatment intensity was associated with equivalent outcomes across subtypes. Conclusion Despite similar long-term outcomes across MDD subtypes, variations in treatment intensity were crucial for achieving these results. Our findings suggest that tailoring treatment plans according to depressive subtype severity and characteristics is essential for effective management. Future research should investigate the genetic and biomolecular bases of these subtypes to further optimize treatment strategies.

Objectives: This study examined the shifts in the suicide trends in Korea during the initial phase of the Fifth Master Plan for Suicide Prevention, using interrupted time series analyses. Methods: Interrupted time series analyses were performed using the monthly suicide data from January 2011 to April 2024. Quasi-Poisson regression models were applied to evaluate the changes in the level and slope of the suicide trend before and after policy implementation. The Autoregressive Integrated Moving Average (ARIMA) and Prophet models were used to compare the actual and predicted counterfactual numbers of suicides during the policy period. Results: The quasi-Poisson regression model revealed a significant change in the trend of suicides among men, with an increasing slope during the policy period. For total suicides, the ARIMA and Prophet models suggested that the actual number of suicides was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 113 and 150 per month. The actual number of suicides among men was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 86 and 92 per month. No significant changes in the suicide trends among women were observed. Conclusion These findings suggest that the initial effects of the Fifth Master Plan for Suicide Prevention were inadequate to curb the rising suicide trends, particularly among men. This study underscores the need for timely policy responses to reverse the current increasing trend in suicides, with particular focus on the male population.

Objectives: This study aimed to investigate factors associated with depression among elderly living alone and those living with a spouse in an urban area. Methods: This study was a community-based, cross-sectional study that included 384 elderly aged 60 years or older.The subjects completed a questionnaire that covered sociodemographic characteristics and chronic medical illnesses.The Korean version of the Short Form of the Geriatric Depression Scale, the Korean version of the Quality of Life-Alzheimer’s Disease (KQOL-AD), and the Korean Mini Mental State Examination in the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease assessment packet were also performed. Results: The participants were divided into two groups: 137 elderly individuals living alone and 247 elderly individuals living with a spouse. Heart disease (odds ratio [OR]=13.099, 95% confidence interval [CI]=1.892-90.697, p=0.009) was identified as a risk factor for depression, while the religion (OR=0.137, 95% CI=0.028-0.668, p=0.014) was found to be a protective factor against depression among elderly individuals living alone. Higher scores on the KQOL-AD scale were found to be protective factors against depression for both elderly individuals living alone (OR=0.742, 95% CI= 0.636-0.867, p<0.001) and those living with a spouse (OR=0.664, 95% CI=0.573-0.771, p<0.001). Conclusions Among elderly living alone in an urban area, heart disease, religion, and the quality of life appear to have an impact on depression. To reduce the risk of depression in the elderly, it is necessary to properly manage heart disease, encourage religious participation, and enhance the quality of life.

Objectives: This study examined the shifts in the suicide trends in Korea during the initial phase of the Fifth Master Plan for Suicide Prevention, using interrupted time series analyses. Methods: Interrupted time series analyses were performed using the monthly suicide data from January 2011 to April 2024. Quasi-Poisson regression models were applied to evaluate the changes in the level and slope of the suicide trend before and after policy implementation. The Autoregressive Integrated Moving Average (ARIMA) and Prophet models were used to compare the actual and predicted counterfactual numbers of suicides during the policy period. Results: The quasi-Poisson regression model revealed a significant change in the trend of suicides among men, with an increasing slope during the policy period. For total suicides, the ARIMA and Prophet models suggested that the actual number of suicides was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 113 and 150 per month. The actual number of suicides among men was significantly higher than the counterfactual number during the policy period, with excess suicides averaging between 86 and 92 per month. No significant changes in the suicide trends among women were observed. Conclusion These findings suggest that the initial effects of the Fifth Master Plan for Suicide Prevention were inadequate to curb the rising suicide trends, particularly among men. This study underscores the need for timely policy responses to reverse the current increasing trend in suicides, with particular focus on the male population.