Objective: Disasters such as pandemics and natural catastrophes cause significant psychological distress, increasing the risk of depression, anxiety, and post-traumatic stress disorder (PTSD). This review aimed to evaluate the effectiveness of remote mental health interventions, such as telepsychiatry, online cognitive behavioral therapy (CBT), mobile applications, and artificial intelligence (AI)-based tools, during disasters. Methods: A comprehensive literature search was conducted using international databases (PubMed, EMBASE, PsycINFO, Web of Science, Scopus, CINAHL) and Korean domestic databases (KISS, RISS, DBpia, KMbase, KoreaMed). Studies published between January 2010 and February 2025 were screened following the PRISMA 2020 guidelines. Two board-certified psychiatrists independently reviewed titles, abstracts, and full texts. Peer-reviewed articles and relevant grey literature, including government manuals and expert guidelines, were included. Results: A total of 147 studies were synthesized, including randomized controlled trials, meta-analyses, observational studies, and policy documents. Evidence showed that remote interventions effectively reduced symptoms of depression, anxiety, and PTSD. Online CBT was beneficial for mild to moderate distress; mobile apps facilitated psychoeducation and symptom tracking; and telepsychiatry ensured care continuity, especially in underserved areas. AI tools showed promise in screening and triage but require better clinical integration. Effectiveness was highest when interventions were implemented early, integrated within stepped-care models, and guided by trained professionals. Conclusion Remote mental health interventions are practical and effective tools for bridging mental health care gaps during disasters. To ensure sustainability, these interventions should be integrated into national disaster mental health frameworks, accompanied by adequate funding, clinician training, legal safeguards, and cultural adaptation.

Background/Aims: A clinical unmet need persists for medications capable of modulating the progression of primary sclerosing cholangitis (PSC). This study aimed to assess the clinical feasibility of HK-660S (beta-lapachone) in PSC. Methods: In this multicenter, randomized, double-blind, placebo-controlled, parallel-group phase 2 trial, participants were assigned in a 2:1 ratio to receive either 100 mg of HK-660S or a placebo twice daily for 12 weeks. The primary outcomes were the reduction in serum alkaline phosphatase (ALP) levels and the percentage of participants showing improvements in PSC severity, as determined by magnetic resonance cholangiopancreatography with the Anali score. Secondary endpoints included changes in liver stiffness and adverse events. Results: The analysis included 21 patients, 15 receiving HK-660S, and six receiving a placebo. Improvements in the Anali score were observed in 13.3% of the HK-660S group, with no improvements in the placebo group. HK-660S treatment resulted in a 15.2% reduction in mean ALP levels, compared to a 6.6% reduction in the placebo group. A stratified ad-hoc analysis based on baseline ALP levels showed a statistically significant response in the HK-660S group among those with ALP levels greater than twice the upper limit of normal, with a 50% responder rate (p=0.05). Additionally, 26.7% of the HK-660S group showed improvements in the enhanced liver fibrosis score, with no improvements in the placebo group. HK-660S was generally well tolerated. Conclusions HK-660S is well tolerated among patients with PSC and may improve bile duct strictures, decrease serum ALP levels, and reduce liver fibrosis (cris.nih.go.kr, Number KCT0006590).

Background/Aims: A clinical unmet need persists for medications capable of modulating the progression of primary sclerosing cholangitis (PSC). This study aimed to assess the clinical feasibility of HK-660S (beta-lapachone) in PSC. Methods: In this multicenter, randomized, double-blind, placebo-controlled, parallel-group phase 2 trial, participants were assigned in a 2:1 ratio to receive either 100 mg of HK-660S or a placebo twice daily for 12 weeks. The primary outcomes were the reduction in serum alkaline phosphatase (ALP) levels and the percentage of participants showing improvements in PSC severity, as determined by magnetic resonance cholangiopancreatography with the Anali score. Secondary endpoints included changes in liver stiffness and adverse events. Results: The analysis included 21 patients, 15 receiving HK-660S, and six receiving a placebo. Improvements in the Anali score were observed in 13.3% of the HK-660S group, with no improvements in the placebo group. HK-660S treatment resulted in a 15.2% reduction in mean ALP levels, compared to a 6.6% reduction in the placebo group. A stratified ad-hoc analysis based on baseline ALP levels showed a statistically significant response in the HK-660S group among those with ALP levels greater than twice the upper limit of normal, with a 50% responder rate (p=0.05). Additionally, 26.7% of the HK-660S group showed improvements in the enhanced liver fibrosis score, with no improvements in the placebo group. HK-660S was generally well tolerated. Conclusions HK-660S is well tolerated among patients with PSC and may improve bile duct strictures, decrease serum ALP levels, and reduce liver fibrosis (cris.nih.go.kr, Number KCT0006590).

Background/Aims: A clinical unmet need persists for medications capable of modulating the progression of primary sclerosing cholangitis (PSC). This study aimed to assess the clinical feasibility of HK-660S (beta-lapachone) in PSC. Methods: In this multicenter, randomized, double-blind, placebo-controlled, parallel-group phase 2 trial, participants were assigned in a 2:1 ratio to receive either 100 mg of HK-660S or a placebo twice daily for 12 weeks. The primary outcomes were the reduction in serum alkaline phosphatase (ALP) levels and the percentage of participants showing improvements in PSC severity, as determined by magnetic resonance cholangiopancreatography with the Anali score. Secondary endpoints included changes in liver stiffness and adverse events. Results: The analysis included 21 patients, 15 receiving HK-660S, and six receiving a placebo. Improvements in the Anali score were observed in 13.3% of the HK-660S group, with no improvements in the placebo group. HK-660S treatment resulted in a 15.2% reduction in mean ALP levels, compared to a 6.6% reduction in the placebo group. A stratified ad-hoc analysis based on baseline ALP levels showed a statistically significant response in the HK-660S group among those with ALP levels greater than twice the upper limit of normal, with a 50% responder rate (p=0.05). Additionally, 26.7% of the HK-660S group showed improvements in the enhanced liver fibrosis score, with no improvements in the placebo group. HK-660S was generally well tolerated. Conclusions HK-660S is well tolerated among patients with PSC and may improve bile duct strictures, decrease serum ALP levels, and reduce liver fibrosis (cris.nih.go.kr, Number KCT0006590).

Objectives: This study examined the experiences and perceptions of healthcare safety management specialists regarding suicide and self-harm incidents in hospitals. The aim was to assess the current state of in-hospital suicide prevention systems, identify vulnerabilities according to the institution type, and suggest directions for improving the related policies and safety guidelines. Methods: A nationwide cross-sectional survey was conducted among 152 healthcare safety management specialists. Data were collected via an online questionnaire between May and June 2022. The survey items included experiences with suicide and self-harm incidents, types of incidents, components of prevention systems, staff training, and follow-up measures. Descriptive and inferential statistics were used for analysis, including chi-square tests for comparisons across hospital types. Results: The most frequently reported suicide methods were hanging (40.1%) and jumping (28.3%), while self-harm incidents often involved self-injury (45.4%). Only 55.3% of respondents indicated that institutional guidelines on suicide/self-harm were present and implemented. Multidisciplinary treatment planning and suicide prevention education for all staff were lacking, showing 32.2% and 27.6%, respectively. Significant differences were observed across hospital types regarding the existence and implementation of prevention guidelines (p<0.01). Conclusion Despite the increasing awareness, substantial variability remains in suicide prevention preparedness across hospital types. Strengthening institutional guidelines, environmental modifications, and multidisciplinary approaches, particularly in nursing hospitals, is critical. Policy support for standardizing mental health consultations and mandatory staff training is essential for enhancing suicide prevention in hospitals.

Objectives: This study examined the psychosocial factors that influence the continuation of clozapine use among individuals with schizophrenia. This examination was conducted through indepth qualitative interviews. Methods: Thirty-one adults diagnosed with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) who had been taking Clozapine ® for at least 3 months were interviewed. Data were collected from May to October 2024 and analyzed using Braun and Clarke’s thematic analysis. Results: Two overarching themes emerged: 1) transformation of perceptions and engagement with treatment, including initial resistance stemming from severe symptoms and lack of insight, experiences of coercive interventions, rebuilding trust in the mental health system, and evolving attitudes toward psychiatric medications; and 2) personal recovery and social support, encompassing coping with side effects, recognizing symptom improvement and renewed hope, and the pivotal roles of family and therapeutic alliance. Trust in healthcare providers and emotional support from family were central to sustained adherence to clozapine. Conclusion Sustained clozapine use in schizophrenia patients is influenced by intertwined psychological, relational, and contextual factors. Acceptance of treatment was supported by symptom improvement, family support, and trust in healthcare providers. These elements contributed to medication adherence and broader functional recovery. A person-centered, integrated approach is essential to promote continued use and long-term outcomes.

Objectives: This study explored the stigma and mental health challenges that vulnerable populations faced during COVID-19 using in-depth interviews with 32 participants. Methods: A generic qualitative methodology was employed, with data collected via face-to-face and Zoom interviews conducted from March to August 2021. Results: Two major themes emerged: the nature of stigmatization and mental health impacts.The participants reported increased exposure to personal information, worsening institutional stigmatization, and routine social exclusion, leading to internalized stigma. They experienced extreme fear, anxiety, depression, hopelessness, suicidal thoughts, and declining physical health. Conclusion The results underscore the necessity of a comprehensive mental health support system that integrates psychological interventions, stigma prevention education, anti-stigma initiatives, and customized policies. Future research should investigate the prolonged impact of pandemic-induced stigma and devise effective strategies for support and intervention.

Objectives: This study explored the stigma and mental health challenges that vulnerable populations faced during COVID-19 using in-depth interviews with 32 participants. Methods: A generic qualitative methodology was employed, with data collected via face-to-face and Zoom interviews conducted from March to August 2021. Results: Two major themes emerged: the nature of stigmatization and mental health impacts.The participants reported increased exposure to personal information, worsening institutional stigmatization, and routine social exclusion, leading to internalized stigma. They experienced extreme fear, anxiety, depression, hopelessness, suicidal thoughts, and declining physical health. Conclusion The results underscore the necessity of a comprehensive mental health support system that integrates psychological interventions, stigma prevention education, anti-stigma initiatives, and customized policies. Future research should investigate the prolonged impact of pandemic-induced stigma and devise effective strategies for support and intervention.