This article summarizes the clinical presentation, importance of early diagnosis, pharmacological strategies, psychosocial interventions, and future perspectives of bipolar disorder. It also emphasizes the need for evidence-based multidisciplinary approaches to this chronic mental illness, which has a rising global lifetime prevalence of approximately 0.5%. This review provides a comprehensive overview addressing diagnostic delays (averaging 5–10 years) and comorbidities.Current concepts: Clinically, bipolar disorder is classified into types 1 and 2 and is characterized by recurrent mania/hypomania, depression, and mixed states. Common psychiatric comorbidities (e.g., anxiety disorders) and physical comorbidities (e.g., cardiovascular disease) contribute to diagnostic delays. Challenges in early diagnosis stem from the absence of biomarkers; however, emerging trends include digital health tools (smartphone apps, wearables) and precision psychiatry integrating genetic and neuroimaging data. Core pharmacological treatments include mood stabilizers (lithium, valproate), atypical antipsychotics (quetiapine, aripiprazole), and selective antidepressants. Combination therapy is used for manic episodes, with cautious antidepressant use in depressive episodes to minimize switch risk. Guideline comparisons reveal regional differences and debate on antidepressant efficacy versus risks. Regarding psychosocial interventions, cognitive-behavioral therapy, psychoeducation, and family therapy are effective for relapse prevention, with digital integration representing a forward-looking approach.Discussion and conclusion: Multidisciplinary integration of pharmacological and psychosocial interventions is essential for improving outcomes in bipolar disorder. Promising directions include novel drugs (NRX-101, lumateperone), gene therapy, artificial intelligence-driven personalization, and efforts to address global disparities. However, developing early diagnostic tools and harmonizing guidelines remain key challenges. Evidence-based strategies can minimize relapse and improve quality of life.

Background: Circadian rhythms have gained importance in the field of psychiatry because of their involvement in overall body functions and their association with mental health. This study investigated the relationship between circadian rhythms, depressive symptoms, anxiety symptoms, and chronotype. Methods: Circadian rhythms, depression and anxiety symptoms, hypomanic symptoms, quality of life, hopelessness, and chronotype were evaluated in 30 healthy adults. Results: Multiple linear regression analysis revealed statistically significant correlations between Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) scores and certain factors. Particularly, Quick Inventory of Depressive Symptomatology (p=0.009), Beck Anxiety Inventory (p=0.03), and Morningness-Eveningness Questionnaire (p<0.001) were found to be significant predictors of the degree of circadian rhythm disruption, as measured by BRIAN. The results showed that irregularity in circadian rhythms was associated with depression and anxiety symptoms, and no significant correlation was observed between chronotype and irregularity in the circadian rhythms. The findings indicated that misalignment between an individual’s chronotype and societal norms, such as work schedules and meal times, could contribute to circadian rhythm disruption, particularly in individuals with an evening chronotype. In contrast, this disruption was associated with an increased risk of anxiety and depression. Conclusion These findings provide important information to better understand the impact of circadian rhythms on mental health.

Background: Circadian rhythms have gained importance in the field of psychiatry because of their involvement in overall body functions and their association with mental health. This study investigated the relationship between circadian rhythms, depressive symptoms, anxiety symptoms, and chronotype. Methods: Circadian rhythms, depression and anxiety symptoms, hypomanic symptoms, quality of life, hopelessness, and chronotype were evaluated in 30 healthy adults. Results: Multiple linear regression analysis revealed statistically significant correlations between Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) scores and certain factors. Particularly, Quick Inventory of Depressive Symptomatology (p=0.009), Beck Anxiety Inventory (p=0.03), and Morningness-Eveningness Questionnaire (p<0.001) were found to be significant predictors of the degree of circadian rhythm disruption, as measured by BRIAN. The results showed that irregularity in circadian rhythms was associated with depression and anxiety symptoms, and no significant correlation was observed between chronotype and irregularity in the circadian rhythms. The findings indicated that misalignment between an individual’s chronotype and societal norms, such as work schedules and meal times, could contribute to circadian rhythm disruption, particularly in individuals with an evening chronotype. In contrast, this disruption was associated with an increased risk of anxiety and depression. Conclusion These findings provide important information to better understand the impact of circadian rhythms on mental health.

Background: Circadian rhythms have gained importance in the field of psychiatry because of their involvement in overall body functions and their association with mental health. This study investigated the relationship between circadian rhythms, depressive symptoms, anxiety symptoms, and chronotype. Methods: Circadian rhythms, depression and anxiety symptoms, hypomanic symptoms, quality of life, hopelessness, and chronotype were evaluated in 30 healthy adults. Results: Multiple linear regression analysis revealed statistically significant correlations between Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) scores and certain factors. Particularly, Quick Inventory of Depressive Symptomatology (p=0.009), Beck Anxiety Inventory (p=0.03), and Morningness-Eveningness Questionnaire (p<0.001) were found to be significant predictors of the degree of circadian rhythm disruption, as measured by BRIAN. The results showed that irregularity in circadian rhythms was associated with depression and anxiety symptoms, and no significant correlation was observed between chronotype and irregularity in the circadian rhythms. The findings indicated that misalignment between an individual’s chronotype and societal norms, such as work schedules and meal times, could contribute to circadian rhythm disruption, particularly in individuals with an evening chronotype. In contrast, this disruption was associated with an increased risk of anxiety and depression. Conclusion These findings provide important information to better understand the impact of circadian rhythms on mental health.

Background: Circadian rhythms have gained importance in the field of psychiatry because of their involvement in overall body functions and their association with mental health. This study investigated the relationship between circadian rhythms, depressive symptoms, anxiety symptoms, and chronotype. Methods: Circadian rhythms, depression and anxiety symptoms, hypomanic symptoms, quality of life, hopelessness, and chronotype were evaluated in 30 healthy adults. Results: Multiple linear regression analysis revealed statistically significant correlations between Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) scores and certain factors. Particularly, Quick Inventory of Depressive Symptomatology (p=0.009), Beck Anxiety Inventory (p=0.03), and Morningness-Eveningness Questionnaire (p<0.001) were found to be significant predictors of the degree of circadian rhythm disruption, as measured by BRIAN. The results showed that irregularity in circadian rhythms was associated with depression and anxiety symptoms, and no significant correlation was observed between chronotype and irregularity in the circadian rhythms. The findings indicated that misalignment between an individual’s chronotype and societal norms, such as work schedules and meal times, could contribute to circadian rhythm disruption, particularly in individuals with an evening chronotype. In contrast, this disruption was associated with an increased risk of anxiety and depression. Conclusion These findings provide important information to better understand the impact of circadian rhythms on mental health.

Background: Circadian rhythms have gained importance in the field of psychiatry because of their involvement in overall body functions and their association with mental health. This study investigated the relationship between circadian rhythms, depressive symptoms, anxiety symptoms, and chronotype. Methods: Circadian rhythms, depression and anxiety symptoms, hypomanic symptoms, quality of life, hopelessness, and chronotype were evaluated in 30 healthy adults. Results: Multiple linear regression analysis revealed statistically significant correlations between Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) scores and certain factors. Particularly, Quick Inventory of Depressive Symptomatology (p=0.009), Beck Anxiety Inventory (p=0.03), and Morningness-Eveningness Questionnaire (p<0.001) were found to be significant predictors of the degree of circadian rhythm disruption, as measured by BRIAN. The results showed that irregularity in circadian rhythms was associated with depression and anxiety symptoms, and no significant correlation was observed between chronotype and irregularity in the circadian rhythms. The findings indicated that misalignment between an individual’s chronotype and societal norms, such as work schedules and meal times, could contribute to circadian rhythm disruption, particularly in individuals with an evening chronotype. In contrast, this disruption was associated with an increased risk of anxiety and depression. Conclusion These findings provide important information to better understand the impact of circadian rhythms on mental health.

Objective: Disruptive behavior disorder (DBD) adversely impacts children and adolescents. However, a comprehensive and cost-effective scale to assess DBD is lacking in Korea. Therefore, this study translated the Disruptive Behavior Disorders Rating Scale (DBDRS) into Korean and analyzed its psychometric properties. Methods: Parents and primary caregivers of non-clinical (n=429) and clinical (n=28) children and adolescents aged 6–15 years were included in the analysis. Confirmatory factor analysis was conducted; further, concurrent validity and internal consistency were investigated using correlation analysis and Cronbach’s alpha, respectively. Furthermore, discriminative capacity was estimated using receiver operating characteristic curve analysis. Results: The four-factor model of K-DBDRS showed good model fit indices and factor loadings, which supported the construct validity of the scale. Strong correlations between K-DBDRS and related measurements were observed, and a robust level of Cronbach’s alpha was confirmed (0.891–0.933). The discriminative capacity of the scale was good, based on the area under the curve values (0.933–0.953). Conclusion This study indicated that the K-DBDRS is an appropriate screening tool for Korean children and adolescents. Thus, this scale can be applied in clinical and community settings to identify children and adolescents with disruptive behavior disorders.

Objectives: ：Based on the fact that cognitive functions decline known as comorbid symptoms of depression can precede depression, this study seeks to observe the effects of depressive symptoms and anxiety symptoms on cognitive function in healthy subjects. Methods: ：To recruit 50 general populations to evaluate cognitive and clinical symptoms and to find out the effects of clinical symptoms on cognitive functions, Pearson correlation and multivariate regression were conducted. Correlation analysis of subdomain cognitive function was conducted for reliability analysis. Results: ：Trail making test-B that evaluates the execution function correlates with depressive symptoms (r=0.300, p=0.03) and age (r=0.323, p=0.02). Depressive symptoms (β=0.304, p=0.03) and age (β=0.335, p=0.01) were significantly related to Trail making test -B (Adjusted R2 =0.148). Subjective cognitive tests correlates with anxiety symptoms (r=0.434, p=0.002). In the correlation between cognitive functional items, Subjective cognitive tests was found to be correlated with other test except Spotter. Conclusions ：In this study, depressive symptoms contribute independently to executive functions in addition to demographic characteristics such as age and duration of education. Given that cognitive decline is a common long-term clinical outcome in depression, we expect active early intervention and evaluation of cognitive function to be helpful.

Objective: More recently, attention has turned to the linkage between childhood trauma and emotional dysregulation, but the evidence in bipolar disorder (BD) is limited. To determine neurobiological relationships between childhood trauma, current anxiety, and impulsivity, we investigated cortical volumetric correlates of these clinical factors in BD. Methods: We studied 36 patients with DSM-5 BD and 29 healthy controls. Childhood trauma, coexisting anxiety, and impulsivity were evaluated with the Korean version-Childhood Trauma Questionnaire (CTQ), the Korean version-Beck Anxiety Inventory (BAI), and the Korean version-Barratt Impulsiveness Scale (BIS). Voxel-based morphometry (VBM) was used to assess gray matter volume (GMV) alterations on the brain magnetic resonance imaging (MRI). Partial correlation analyses were conducted to examine associations between the GMV and each scale in the BD group. Results: Childhood trauma, anxiety, and impulsivity were interrelated in BD. BD patients revealed significant inverse correlations between the GMV in the right precentral gyrus and CTQ scores (r=-0.609, p<0.0003); between the GMV in the left middle frontal gyrus and BAI scores (r=-0.363, p=0.044). Moreover, patients showed similar tendency of negative correlations between the GMV in the right precentral gyrus and BIS scores; between the GMV in the left middle frontal gyrus and CTQ scores. Conclusion The present study provides evidence for a neural basis between childhood trauma and affect regulations in BD. The GMV alterations in multiple frontal lobe areas may represent neurobiological markers for anticipating the course of BD.

OBJECTIVES: This study tried to explore the prevalence of chronic physical diseases in patients with schizophrenia and its effects on total medical costs. METHODS: The Health Insurance Review and Assessment Service data in 2014–2015 was employed. Only the injuries and diseases, identically diagnosed 3 times or more as a major or minor injury and disease, were classified into chronic physical diseases to improve data accuracy. Total medical costs included out-of-pocket and insurer's costs from health care system perspective. RESULTS: It was shown that 24.5%, 17.3% and 23.4% of schizophrenia patients had one, two and three or more chronic physical diseases, respectively. There was a high prevalence of not only metabolic, but also musculoskeletal, diseases in those patients. The amount of 2015 total medical costs of patients with schizophrenia in 2014 was about 1.08 trillion won. The factors affecting the costs included sex, age, number of chronic physical diseases, and health insurance status. CONCLUSIONS: It is considered that clinical practice guidelines based on personal diseases may not sufficiently solve the problems for comorbidities in schizophrenia patients. Accordingly, it should be required to develop models for new types of medical systems capable of treating and caring varied illnesses at the same time.
Comorbidity ; Data Accuracy ; Delivery of Health Care ; Humans ; Insurance, Health ; Prevalence ; Schizophrenia