Objective: The purpose of this study was to examine whether attachment insecurity, stigma, and certain demographic and medical factors predict depression and anxiety in people living with HIV (PLWH). Methods: Participants were 147 PLWH who visited the outpatient infection clinic in Kyungpook National University Hospital (KNUH; Daegu, South Korea) between June 2020 and January 2021. We measured HIV-related stigma, attachment anxiety and avoidance, depressive symptoms, and anxiety symptoms. Results: Logistic regression analysis showed that unemployment, longer time receiving antiretroviral therapy, higher attachment avoidance, and higher attachment anxiety were significant predictors of depression. Results also showed that longer time receiving antiretroviral therapy, higher attachment anxiety, and concern with public attitudes were significant predictors of anxiety. Conclusion In addition to education to reduce public stigma, interventions to reduce PLWH’s self-stigma should continue. We suggest attachment-based psychotherapy as an effective intervention to improve PLWH’s mental health.

Objective: The purpose of this study is to identify personality types that can influence breast cancer screening (BCS) compliance among Korean women with breast cancer using a mixed-method approach. Methods: The participants consisted of 93 women who underwent surgery for breast cancer between July 2010 and March 2012. The demographic and medical characteristics of the participants were evaluated through structured interviews. To identify personality types, in-depth interviews were performed and the transcribed interviews were evaluated using interpretive phenomenological analysis. The participants were categorized into two groups (compliance and non-compliance) based on compliance with the Korean Breast Cancer Society recommendations for BCS. Results: Five personality types were identified through phenomenological analysis. There were significant differences in the chi-square test results for the BCS compliance and non-compliance groups according to age (p=0.048), cancer stage (p<0.001), and personality types (p=0.018). Logistic regression showed that the odds ratio for compliance with BCS was 9.35 (p=0.01) for individuals with a cautious-organized personality type, 9.38 (p=0.02) for those with a cautious-dependent personality, and 10.58 (p=0.04) for those with a sensitive-downcast personality compared to those with a cautious personality type. Conclusion Participants with cautious-organized, cautious-dependent, and sensitive-downcast personality types were less likely to follow the BCS recommendations than those with a cautious personality type. This study provides a basis for the future development of an effective questionnaire to investigate the personality types of individuals with breast cancer in order to predict compliance with BCS.

Following the development of human immunodeficiency virus (HIV) treatments, the mean lifespan of patients with an HIV infection has increased to a level comparable to the general population. Patients receiving HIV treatment can achieve viral suppression and perform routine activities without the risk of infection transmission. Recently, the quality of life (QoL) and mental health of patients are becoming the primary outcomes in HIV treatment. The objective of this review was to investigate psychiatric disorders in patients with an HIV infection and available treatment programs. A search for clinical studies and scientific publications was performed. Patients with an HIV infection had a higher prevalence of psychiatric disorders than the general population. The psychopathological factors in HIV infection included neurobiological changes of infection, side-effects of medications, negative social perception, and unresolved intrapsychic conflicts. Severe and unmanaged psychiatric disorders with HIV infection negatively impacted HIV infection transmission and treatment adherence. However, psychiatric treatment programs and referrals to a psychiatric professional were found to be insufficient in most countries. This review revealed a need for psychiatric interventions in clinical practice to improve patients’ mental health and HIV treatment adherence. Psychiatric interventions integrated with conventional HIV treatment can be efficacious to achieve this goal. In addition, clinicians need to investigate and recognize HIV-related stigma as the relationship between patients and clinicians has a significant role in the patient’s treatment adherence.

OBJECTIVE: To identify attachment insecurity as an associative factor with unresolved psychological distress 1 year after surgery in the early breast cancer (BC) population. METHODS: One-hundred fourteen participants completed the Hospital Anxiety and Depression Scale (HADS) and the Experiences in Close Relationship (ECR-M36) questionnaire within 1 week (baseline) and at 1-year post-surgery (follow-up). Participants were categorized into the distress and the non-distress groups based on a HADS-total score cut-off of 15. Logistic regression analysis revealed predictive factors of distress at follow-up. RESULTS: At baseline, 53 (46.5%) participants were found to be in the distress group. The degree of distress decreased over 1 year (p= 0.003); however, 43 (37.7%) showed significant remaining distress at follow-up. Baseline scores of the ECR-M36 avoidance [odds ratio (OR)=1.045, 95% confidence interval (CI)=1.002–1.090] and HADS-total (OR=1.138, 95% CI=1.043–1.241) were predictors of distress at follow-up. CONCLUSION: A substantial proportion of early BC patients suffer distress even one-year after surgery. Avoidant attachment appeared to be an influential factor on distress in early BC patients. Moreover, the finding that initial distress level could predict one at 1-year post-operation warrant a screening and management of distress along with BC treatment.
Anxiety ; Breast Neoplasms* ; Breast* ; Depression ; Follow-Up Studies* ; Humans ; Logistic Models ; Mass Screening

OBJECTIVE: Previous studies have reported that childhood maltreatment experiences could induce biological and psychological vulnerability in depressive disorders. However, it is still unclear that type-specific effects of childhood maltreatment on psychological resilience, depressive symptoms and interactions among childhood maltreatment experiences, resilience, and depressive symptoms. METHODS: A total of 438 medical students were included in the study. The Childhood Trauma Questionnaire-Short Form, the Conner-Davidson Resilience Scale, and the Beck Depression Inventory were used for measuring childhood maltreatment experiences, psychological resilience, and depressive symptoms, respectively. We investigated the effects of childhood maltreatment experiences on resilience and depressive symptoms using correlation analysis. In addition, we analyzed the mediating effect of resilience on the association between childhood maltreatment and symptoms of depression. RESULTS: Among childhood maltreatment, emotional neglect was a significant predictor of the scores of low resilience and high depressive symptoms in both gender groups (all ps < 0.05). Furthermore, resilience was found to be a mediator connecting emotional neglect experiences with depressive symptoms. CONCLUSION: Our results suggest that emotional neglect has detrimental effects on mood and resilience, and clinicians need to focus on the recovery of resilience when they deal with depressive symptoms in victims of childhood maltreatment.
Depression ; Depressive Disorder ; Humans ; Negotiating ; Resilience, Psychological ; Students, Medical

OBJECTIVE: The Modified Experiences in Close Relationships (ECR-M36) scale was developed for medically ill, older individuals in 2008 (Toronto, Canada, department of psychosocial oncology and palliative care, Princess Margaret Hospital). The scale has displayed satisfactory reliability and validity. This study aimed to test the reliability and validity of the Korean version of Modified Experiences in Close Relationships (K-ECR-M36) questionnaire in female patients with breast cancer. METHODS: A total of 199 post-operative breast cancer patients completed the K-ECR-M36 as well as other psychological measures including the Revised Adult Attachment Scale (RAAS), World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF), and Hospital Anxiety and Depression Scale (HADS). The reliability and validity of the K-ECR-M36 were evaluated. Explorative factor analysis was conducted to identify the factor structure of the K-ECR-M36. RESULTS: The K-ECR-M36 showed good internal consistency (Cronbach's alpha=0.87) and reasonable test-retest reliability (r=0.752, p<0.001). The total as well as avoidance and anxiety subscales demonstrated construct validity with the RAAS, the HADS, and the WHOQOL-BREF. Factor analysis revealed four-factor structure which was originally proposed by Brennan, Clark, and Shaver (1998). CONCLUSION: These findings support that the K-ECR-M36 has satisfactory reliability, validity and factor structure among patients with breast cancer.
Adult* ; Anxiety ; Breast Neoplasms ; Canada ; Depression ; Female ; Humans ; Palliative Care ; Quality of Life ; Reproducibility of Results* ; World Health Organization

OBJECTIVE: The Young Schema Questionnaire (YSQ) is a self-report measure of early maladaptive schemas and is currently in its third revision; it is available in both long (YSQ-L3) and short (YSQ-S3) forms. The goal of this study was to develop a Korean version of the YSQ-S3 and establish its psychometric properties in a Korean sample. METHODS: A total of 542 graduate medical students completed the Korean version of the YSQ-S3 and several other psychological scales. A subsample of 308 subjects completed the Korean YSQ-S3 both before and after a 2-year test-retest interval. Correlation, regression, and confirmatory factor analyses were performed on the data. RESULTS: The internal consistency of the 90-item Korean YSQ-S3 was 0.97 and that of each schema was acceptable, with Cronbach's alphas ranging from 0.59 to 0.90. The test-retest reliability ranged from 0.46 to 0.65. Every schema showed robust positive correlations with most psychological measures. The confirmatory factor analysis for the 18-factor structure originally proposed by Young, Klosko, and Weishaar (2003) showed that most goodness-of-fit statistics were indicative of a satisfactory fit. CONCLUSION: These findings support the reliability and validity of the Korean version of the YSQ-S3.
Humans ; Psychometrics ; Surveys and Questionnaires ; Reproducibility of Results* ; Students, Medical* ; Weights and Measures

OBJECTIVE: It was previously suggested that the malic enzyme 2 (ME2) as the candidate gene for psychosis in fine mapping of chromosome 18q21. Chromosome 18q21 is also one of the possible regions that can contribute to addiction. METHODS: We performed a pilot study for discovering candidate gene of chromosome 18q21 in the methamphetamine abusers for elucidating the candidate gene for methamphetamine addiction leading to psychosis. We have selected 30 unrelated controls (16 males, 14 females; age=59.8+/-10.4) and 37 male methamphetamine abusers (age=43.3+/-7.8). We analyzed 20 single nucleotide polymorphisms (SNPs) of 7 neuronal genes in chromosome 18q21 for DNA samples that was checked for the data quality and genotype error. The association between the case-control status and each individual SNP was measured using multiple logistic regression models (adjusting for age and sex as covariates). And we controlled false discovery rate (FDR) to deal with multiple testing problem. RESULTS: We found 3 significant SNPs of 2 genes in chromosome 18q21 (p-value<0.05; adjusting for age as covariate) in methamphetamine abusers compared to controls. We also found 2 significant SNPs of 1 gene (p-value<0.05; adjusting for age and sex as covariates) (rs3794899, rs3794901:MAPK4). Two SNPs in MAPK4 gene were significant in both statistical groups. CONCLUSION: MAPK4, the gene for mitogen-activated protein kinase 4, is one of the final 6 candidate genes including ME2 in 18q12-21 in our previous finemapping for psychosis. Our results suggest that MAPK4 can be a candidate gene that contribute to the methamphetamine addiction leading to psychosis.
Case-Control Studies* ; Comorbidity ; DNA ; Female ; Genotype ; Humans ; Logistic Models ; Male ; Methamphetamine* ; Neurons ; Pilot Projects* ; Polymorphism, Single Nucleotide ; Protein Kinases ; Psychotic Disorders ; Data Accuracy ; Substance-Related Disorders

Acamprosate reduces the craving for alcohol by decreasing glutamate activity and increasing gamma-aminobutyric acid (GABA) action in patients with alcohol dependence. Acamprosate has tolerable side effects that include diarrhea, headache, dizziness and pruritus. In this study, we report acamprosate-induced extrapyramidal symptoms in an elderly patient with no history of neurologic disease. Severe extrapyramidal symptoms developed two days after the administration of acamprosate and improved over one week after the acamprosate was stopped. Extrapyramidal symptoms are commonly associated with dopamine receptor antagonists. However, there have been several reports of extrapyramidal symptoms occurring with drugs targeting other systems, including GABA, glutamate and serotonin. Acamprosate may decrease dopamine levels in the ventral tegmental area mediated by glutamatergic action and thus cause extrapyramidal symptoms. We suggest that acamprosate carries the risk of causing extrapyramidal symptoms.
Aged* ; Alcoholism* ; Diarrhea ; Dizziness ; Dopamine ; Dopamine Antagonists ; gamma-Aminobutyric Acid ; Glutamic Acid ; Headache ; Humans ; Pruritus ; Serotonin ; Ventral Tegmental Area

OBJECTIVES: Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. METHODS: Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. RESULTS: Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p< 0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after di-agnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. CONCLUSIONS: We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.
Breast ; Breast Neoplasms* ; Delayed Diagnosis* ; Diagnosis ; Female ; Gyeongsangbuk-do ; Humans ; Korea ; Logistic Models ; Mammography ; Marriage* ; Mass Screening ; Mortality ; Psychology* ; Risk Factors ; Time-to-Treatment