Objective: To assess the incidence and risk of psychiatric disorders, including depression, anxiety, and trauma-related disorders, in individuals who underwent globe and orbital ablative surgeries compared to a matched control group. Methods: This retrospective cohort study used Korean National Health Insurance Service data. The cohort included 338,767 individuals, with 16,545 in the surgery group (orbital exenteration, enucleation, or evisceration, 2003–2021) and 322,222 matched controls. After exclusions, 12,965 patients were matched with 251,445 controls via propensity score matching. The cumulative incidence and risk of psychiatric disorders, including depression (F32.x, F34.0, F34.1), anxiety (F40.x, F41.x), and trauma-related disorders (F43.x), over three years post-surgery. Kaplan-Meier analysis assessed cumulative incidence, while Cox proportional hazards regression estimated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results: A total of 264,410 individuals (mean age, 54.4 years; 63.3% man) were included. The surgery group had significantly higher cumulative incidence of psychiatric disorders (log-rank p<0.001). The incidence rate ratio was 1.63 (95% CI, 1.52–1.75). Risk was greatest in younger individuals (incidence rate ratio, 2.15; 95% CI, 1.75–2.64) and men (1.77 vs. 1.48 in women). Higher comorbidities were associated with lower risk (HR: 0.91 in men, 0.90 in women), as was higher socioeconomic status (HR: 0.76 in men, 0.68 in women). Conclusion Globe and orbital ablative surgeries were associated with significantly increased psychiatric risk, particularly in younger men. Higher comorbidities and socioeconomic status appeared to mitigate this risk. Integrated mental health support should be considered in postoperative care.

Objective: Medication adherence is crucial for long-term outcomes in bipolar disorder. Despite the rising use of aripiprazole, a longacting injectable for bipolar disorder, once monthly to improve adherence and manage side effects, research on its effects in South Korean patients with bipolar disorder is limited. Methods: In this non-interventional, retrospective study, medical records were used to analyze aripiprazole once monthly treatment from its initiation in routine clinical settings. The data were collected at 1, 3, 6, 9, and 12 months. Functional level and symptom severity were measured using the Global Assessment of Functioning (GAF), Clinical Global Impression–Bipolar–Severity (CGI-BP-S), Young Mania Rating Scale (YMRS), Korean version of the Montgomery–Åsberg Depression Rating Scale (K-MADRS), and Hamilton Anxiety Rating Scale (HAM-A). Additionally, the dosages and number of pills of mood stabilizers and antipsychotics, and the total number of medications, were recorded. Results: Among 24 patients with bipolar disorder, significant functional improvement and symptom relief were observed over 1 year, with a significant reduction in total pill count and dosages of mood stabilizers and antipsychotics. Specifically, the GAF score increased by 25.7% (p=0.001), while CGI-BP-S, YMRS, K-MADRS, and HAM-A scores decreased by 24.4% (p=0.001), 81.2% (p=0.001), 36.2% (p=0.002), and 36.1% (p=0.003), respectively. Six patients reported side effects such as akathisia, tremors, weight gain, and headache, but no severe adverse effects were noted. Conclusion This study showed significant improvement in functional outcomes and mood symptoms with monthly aripiprazole treatment in bipolar disorder. Mood stabilizer and antipsychotic dosages were also reduced. The results highlight the proactive role of longacting injectable antipsychotics in enhancing functioning, symptoms, and quality of life in bipolar disorder.

Objective: Perinatal depression often remains undertreated due to concerns about antidepressant exposure during fertility treatment, pregnancy, or breastfeeding. Non-pharmacological, home-based interventions such as transcranial direct current stimulation (tDCS) present a promising alternative; however, real-world evidence in perinatal populations remains limited. Methods: This prospective observational study included 38 women who received infertility, pregnancy, or postpartum treatment at four hospitals in South Korea. Participants self-administered anodal tDCS targeting the left dorsolateral prefrontal cortex for 20–28 sessions over 4 weeks. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) at baseline and weeks 2, 4, and 8. Subjective health perception was measured at baseline using a 5-point Likert scale. Results: Time had a significant effect on depressive symptoms (Wald χ2=90.75, p<0.001), with the largest reduction observed during the first 2 weeks. The CES-D scores remained significantly lower than baseline at week 8, 4 weeks after treatment ended. Subjective health perception was significantly associated with baseline depression severity (Wald χ2=26.41, p<0.001), and its interaction with time was also significant (Wald χ2=320.18, p<0.001). Participants with poorer perceived health (scores 4–5) experienced greater depressive symptom reductions than those with more favorable perceptions (scores 1–2). Conclusion Home-based tDCS was feasible and associated with clinically meaningful improvement in depressive symptoms among perinatal women. Those who initially perceived their health more negatively showed greater response, suggesting subjective health perception may serve as a useful moderator and potential marker to inform personalized treatment strategies.

Background: This study examined gender differences in occupational stress, depressive symptoms, and suicidal ideation by considering the potential moderating effect of grit on Korean employees. Methods: A total of 11,369 participants (7,735 men and 3,634 women) aged 19–65 years, employed across 18 private companies and local government organizations in Korea, completed questionnaires including the Short Grit Scale, Korean Occupational Stress Scale, and Center for Epidemiologic Studies Depression Scale between April 2020 and March 2022.Suicidal ideation was assessed based on its presence or absence. Mediation and moderation analyses were performed using the Statistical Package for the Social Sciences PROCESS macro. Results: Depressive symptoms partially mediated the relationship between occupational stress and suicidal ideation in male employees, whereas depressive symptoms fully mediated the relationship in female employees. Grit moderated the relationship between depressive symptoms and suicidal ideation in male employees but not in female employees.Furthermore, the moderated mediating effect of grit in male employees on the relationship between occupational stress and suicidal ideation provided less protection in cases of severe depression. The cross-sectional design does not allow for causal inferences. Conclusion These findings contribute to understanding of the gender differences in the impact of depressive symptoms on the relationship between occupational stress and suicidal ideation, as well as the protective effect of grit. These findings highlight the need for genderspecific approaches to prevent suicidal ideation among employees.

Objectives: This study aimed to assess the clinical burden, a critical determinant of medication adherence in patients with schizophrenia, after the administration of Aripiprazole once-monthly (AOM). Methods: This study was a retrospective, non-interventional, multicenter, naturalistic observational study conducted through the analysis of participants’ electronic medical records. Study participants were recruited from eight sites. Data were collected at baseline, defined as the time of AOM administration, and at 1, 3, 6, 9, and 12 months thereafter. The primary outcome measure was the change in the Clinical Global Impression-Clinical Benefit (CGI-CB) score over 12 months, and the secondary outcome measure was the change in the Clinical Global Impression-Improvement (CGI-I) score. Results: The data of 139 participants were analyzed, revealing a statistically significant decrease of 26.8% in CGI-CB scores and 13.4% in CGI-I scores over 12 months. Upon comparison between adjacent visit intervals, significant reductions were observed for both measures between month 3 and month 6. Conclusions This study is the first multicenter investigation to simultaneously evaluate the clinical efficacy and tolerability of transitioning to AOM in the context of polypharmacy. The study suggested that AOM may contribute to reducing the clinical burden, thereby improving the quality of life for patients with schizophrenia.

Objective: This study aimed to examine the psychiatric impact of the Seoul Halloween crowd crush on individuals related to the victims compared to the general population. It also explores the moderating effect of resilience on the relationship between trauma exposure and psychiatric symptoms. Methods: In total, 2,220 participants completed various post-incident questionnaires (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Hwa-byung symptom scale, post-traumatic stress disorder checklist for DSM-5, and Brief Resilience Scale) 30 days after the incident. Moderation analyses were conducted using the PROCESS macro in the statistical package for the social sciences. Results: Individuals related to the victims exhibited higher symptom severity and a greater risk for clinically significant levels of depression, anxiety, anger, and post-traumatic stress disorder (PTSD) (odds ratio=3.28, 3.33, 1.51, and 4.39 respectively). The impact of relevance to victims on anxiety and PTSD symptoms was moderated by resilience, with a stronger effect observed for individuals with low resilience (β=3.51, 95% confidence interval [CI] 2.78–4.24 for anxiety and β=14.53, 95% CI 12.43–16.63 for PTSD) than for those with high resilience (β=1.69, 95% CI 0.72–2.65 for anxiety and β=8.33, 95% CI 5.56–11.09 for PTSD). Conclusion When related to the victims, it was found that not only PTSD, but also depression, anxiety, and anger could intensify. Resilience emerged as a potential buffer against these adverse effects, emphasizing its significance in mitigating the psychiatric impact of community trauma.

Background: It is unclear how exposure to and perception of community trauma creates a mental health burden. This study aimed to examine the psychological distress trends among community residents in acute stress reaction, acute stress disorder, and post-traumatic stress disorder phases following the Seoul Halloween crowd crush. Methods: A three-wave repeated cross-sectional survey was conducted with participants after the incident. Analysis of covariance (ANCOVA) with post hoc Bonferroni test was adopted to examine temporal changes in psychological distress and psychological outcomes resulting from media impacts. A two-way ANCOVA was adopted to examine the interaction effects of time and relevance to victims on psychological distress. Results: A total of 807, 1,703, and 2,220 individuals participated in the three waves. Anxiety (estimated mean [standard error of the mean]: 2.28 [0.03] vs. 2.12 [0.02] vs. 2.03 [0.02]; P < 0.001), depression (2.22 [0.03] vs. 2.01 [0.02] vs. 1.90 [0.02]; P < 0.001), and anger (2.70 [0.03] vs. 2.66 [0.02] vs. 2.49 [0.02]; P < 0.001) gradually improved. However, sense of safety initially worsened and did not recover well (2.96 [0.03] vs. 2.75 [0.02] vs. 2.77 [0.02];P < 0.001). The interaction effect of time and relevance to the victim were significant in depression (P for interaction = 0.049), anger (P for interaction = 0.016), and sense of safety (P for interaction = 0.004). Among participants unrelated to the victim, those exposed to graphics exhibited higher levels of anxiety (2.09 [0.02] vs. 1.87 [0.07]; P = 0.002), depression (1.99 [0.02] vs. 1.83 [0.07]; P = 0.020), and anger (2.71 [0.03] vs. 2.47 [0.08]; P = 0.003) at W2 and higher anger (2.49 [0.02] vs. 2.31 [0.06]; P = 0.005) at W3. Conclusion Community residents indirectly exposed to trauma also experienced psychological distress in the early stages after the incident. A significant impact of media which might have served as a conduit for unfiltered graphics and rumors was also indicated.

Objectives: This study aimed to assess the clinical burden, a critical determinant of medication adherence in patients with schizophrenia, after the administration of Aripiprazole once-monthly (AOM). Methods: This study was a retrospective, non-interventional, multicenter, naturalistic observational study conducted through the analysis of participants’ electronic medical records. Study participants were recruited from eight sites. Data were collected at baseline, defined as the time of AOM administration, and at 1, 3, 6, 9, and 12 months thereafter. The primary outcome measure was the change in the Clinical Global Impression-Clinical Benefit (CGI-CB) score over 12 months, and the secondary outcome measure was the change in the Clinical Global Impression-Improvement (CGI-I) score. Results: The data of 139 participants were analyzed, revealing a statistically significant decrease of 26.8% in CGI-CB scores and 13.4% in CGI-I scores over 12 months. Upon comparison between adjacent visit intervals, significant reductions were observed for both measures between month 3 and month 6. Conclusions This study is the first multicenter investigation to simultaneously evaluate the clinical efficacy and tolerability of transitioning to AOM in the context of polypharmacy. The study suggested that AOM may contribute to reducing the clinical burden, thereby improving the quality of life for patients with schizophrenia.

Background: This study examined gender differences in occupational stress, depressive symptoms, and suicidal ideation by considering the potential moderating effect of grit on Korean employees. Methods: A total of 11,369 participants (7,735 men and 3,634 women) aged 19–65 years, employed across 18 private companies and local government organizations in Korea, completed questionnaires including the Short Grit Scale, Korean Occupational Stress Scale, and Center for Epidemiologic Studies Depression Scale between April 2020 and March 2022.Suicidal ideation was assessed based on its presence or absence. Mediation and moderation analyses were performed using the Statistical Package for the Social Sciences PROCESS macro. Results: Depressive symptoms partially mediated the relationship between occupational stress and suicidal ideation in male employees, whereas depressive symptoms fully mediated the relationship in female employees. Grit moderated the relationship between depressive symptoms and suicidal ideation in male employees but not in female employees.Furthermore, the moderated mediating effect of grit in male employees on the relationship between occupational stress and suicidal ideation provided less protection in cases of severe depression. The cross-sectional design does not allow for causal inferences. Conclusion These findings contribute to understanding of the gender differences in the impact of depressive symptoms on the relationship between occupational stress and suicidal ideation, as well as the protective effect of grit. These findings highlight the need for genderspecific approaches to prevent suicidal ideation among employees.

Background: This study examined gender differences in occupational stress, depressive symptoms, and suicidal ideation by considering the potential moderating effect of grit on Korean employees. Methods: A total of 11,369 participants (7,735 men and 3,634 women) aged 19–65 years, employed across 18 private companies and local government organizations in Korea, completed questionnaires including the Short Grit Scale, Korean Occupational Stress Scale, and Center for Epidemiologic Studies Depression Scale between April 2020 and March 2022.Suicidal ideation was assessed based on its presence or absence. Mediation and moderation analyses were performed using the Statistical Package for the Social Sciences PROCESS macro. Results: Depressive symptoms partially mediated the relationship between occupational stress and suicidal ideation in male employees, whereas depressive symptoms fully mediated the relationship in female employees. Grit moderated the relationship between depressive symptoms and suicidal ideation in male employees but not in female employees.Furthermore, the moderated mediating effect of grit in male employees on the relationship between occupational stress and suicidal ideation provided less protection in cases of severe depression. The cross-sectional design does not allow for causal inferences. Conclusion These findings contribute to understanding of the gender differences in the impact of depressive symptoms on the relationship between occupational stress and suicidal ideation, as well as the protective effect of grit. These findings highlight the need for genderspecific approaches to prevent suicidal ideation among employees.