1.Association Between Smoking and Generalized Anxiety Disorder in Korean Adults:Analysis Based on the Korean National Health and Nutrition Examination Survey
Hui-jong YU ; Young-Myo JAE ; Sae-Heon JANG ; Kyoung-Hwan LEE ; Kyoung-Beom KIM
Journal of the Korean Society of Biological Therapies in Psychiatry 2024;30(2):29-35
Objectives:
This study was designed to investigate whether there was a relationship between smoking and generalized anxiety disorder (GAD) in a Korean adult group.
Methods:
This study was based on the data from eighth Korean National Health and Nutrition Examination Survey (KNHANES). The subjects were 5,273 adults aged 19 years or older. Smoking group was classified into non-smoker, exsmoker, and current smoker. GAD was defined as above 10 points of GAD-7. The correlation between smoking and GAD was examined using complex sample design after adjusting confounders.
Results:
For male, smoking did not have a significant effect on GAD, but for female, current smokers were significantly more likely to have GAD than non-smokers (odds ratio=2.33, p=0.012).
Conclusions
The association between smoking and GAD was found only in female. The result means that a differentiated approach is needed for female and male in the management of smokers and patients with GAD.
2.Prevalence, Sociodemographic Factors and Association With Mental Disorders of Parasuicide and Deliberate Suicide Attempts in Korean General Population
Yong Seong LEE ; Jimin LEE ; Sung Man CHANG ; Byung-Soo KIM
Journal of the Korean Society of Biological Therapies in Psychiatry 2024;30(2):36-43
Objectives:
The aim of this study is to identify the prevalence of parasuicide and deliberate suicide attempts in the general population of Korea, as well as their associations with sociodemographic risk factors and mental disorders.
Methods:
This study utilized data from the 2021 National Mental Health Survey of Korea. The survey was conducted between June and August 2021, involving 5,511 respondents aged 18 to 79 years living in communities. The Korean version of the Composite International Diagnostic Interview (K-CIDI) was used as the survey instrument. Logistic regression analysis was employed for statistical analysis.
Results:
The prevalence of parasuicide was 1.1%, and that of deliberate suicide attempts was 0.9%. The risk of parasuicide increased among younger age, while no significant associations with other sociodemographic factors were found.The risk of deliberate suicide attempts was associated with being divorced, separated or widowed and low income. Both parasuicide and deliberate suicide attempts were associated with depressive disorders, anxiety disorders, alcohol use disorders and nicotine use disorders.
Conclusions
The sociodemographic risk factors of parasuicide and deliberate suicide attempts are distinct. This study provides valuable insights into the mental disorder-related traits associated with parasuicide and deliberate suicide attempts, which could be useful in developing future suicide prevention programs.
3.Novel Antidepressants Targeting Neurosteroids
Journal of the Korean Society of Biological Therapies in Psychiatry 2024;30(3):45-51
Depressive disorders are prevalent worldwide. Despite the availability of various antidepressants, treatment responses remain suboptimal, with disappointing remission rates. Recent advancements in antidepressant development have shifted focus to mechanisms beyond traditional monoamine neurotransmitters, such as serotonin and norepinephrine. Allopregnanolone, a neurosteroid, acts as a positive allosteric modulator of GABA A receptors, playing a significant role in regulating mood and anxiety. Fluctuations in allopregnanolone levels during reproductive cycles contribute to mood disorders such as premenstrual dysphoric disorder, postpartum depression (PPD), and menopausal depression. Recently, the Food and Drug Administration approved two novel antidepressants, brexanolone (IV) and zuranolone (oral). These synthetic analogs of allopregnanolone offer fast-acting relief for PPD by enhancing GABAergic inhibition. Additionally, these neurosteroid-based therapies provide new hope for patients with depression beyond PPD, due to their rapid onset of action. However, concerns regarding long-term safety and the potential for misuse remain, necessitating further research.This review explores the relationship between neurosteroids and depression, with a focus on the mechanisms and clinical applications of brexanolone and zuranolone in treating mood disorders.
4.A Study of Factors Affecting Quality of Life in Elderly:Based on the 8th Korean National Health and Nutrition Examination Survey
Journal of the Korean Society of Biological Therapies in Psychiatry 2024;30(3):69-75
Objectives:
We examined the factors influencing heath related quality of life among elderly in Korea.
Methods:
The subjects of this research were 1,342 elderly people aged 65 years or over in Korea. Health related quality of life was measured using EuroQol-5 dimension (EQ-5D), and depression was measured using Patient Health Questionnaire-9. Statistical differences among the EQ-5D index score was analyzed using analysis of covariance and logistic regression analysis based on sociodemographic characteristics, subjective health perception, stress perception degree and depression severity.
Results:
Depression severely reduced health related quality of life. General characteristics having significant influence on health related quality of life index score included gender, income, education, marital status, subjective health perception, stress perception degree and severity of depression.
Conclusions
Depression is associated with severe reduction of the health related quality of life on EQ-5D index score.Social attention and further study of depression will be needed for improving the health related quality of life among elderly with depression.
5.Meditation-Induced Psychosis: Recurrent Case Reports in the Same Patient
Journal of the Korean Society of Biological Therapies in Psychiatry 2024;30(3):103-105
Meditation has been practiced across various cultures for religious, self-cultivation, and mental health purposes and has recently been integrated into psychiatric care. While meditation has demonstrated efficacy in managing insomnia, depression, anxiety, and schizophrenia, its potential adverse effects are often overlooked. Among these, meditation-induced psychosis is particularly concerning due to the severe subjective distress and functional impairment it causes.This case report presents a rare instance of repeated meditation-induced psychosis in a single patient. The patient, a 52-year-old woman, experienced psychotic episodes twice, each following intense meditation under significant stress, with an interval of over 1 year between the recurrences. Her symptoms included delusions, auditory and visual hallucinations, and inappropriate behavior, leading to hospitalization. Treatment with paliperidone successfully alleviated her symptoms on both occasions. This case highlights the dual nature of meditation as both a therapeutic tool and a potential risk factor in stressful situations or in individuals with a history of psychosis. The lack of specific guidelines on the contraindications of meditation in clinical settings emphasizes the need for cautious application, especially in vulnerable populations. Further research is essential to establish evidence-based guidelines that consider both the benefits and risks of meditation therapy, ensuring its safe and effective use in psychiatric practice.
6.Maternal Postpartum Depression Symptoms and Related Factors Performed Upon Discharge From Neonatal Intensive Care Unit for Premature Infants
Jiheon KIM ; Na Yeoung KONG ; Yang Tae KIM ; Sung-Won JUNG ; Hee Cheol KIM ; Jae-Hyun PARK ; Hojun LEE
Journal of the Korean Society of Biological Therapies in Psychiatry 2024;30(3):52-60
Objectives:
This study aims to investigate the prevalence and severity of postpartum depression symptoms in high-risk mothers following preterm birth upon discharge and to identify related factors and risk factors for these symptoms.
Methods:
The study retrospectively analyzed medical records of women with high-risk pregnancies who delivered premature infants (gestational age ≤35 weeks and weight <2,000 g) between January 2019 and January 2024. Postpartum depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire-9 (PHQ-9).
Results:
The study included 96 mothers who gave birth to premature infants and completed both the EPDS and PHQ-9 at discharge. Mean EPDS score was 8.35±4.95, and the mean PHQ-9 score was 3.32±3.43. The prevalence of depressive symptoms and their association with various maternal and neonatal factors were analyzed. Maternal age showed a significant correlation with EPDS scores (r=0.291, p=0.004).
Conclusions
In this study, it was identified that high-risk pregnancies resulting in premature birth experience a considerable prevalence of depressive symptoms. Identifying related factors is crucial for early intervention and support for this vulnerable group.
7.Decision Making Delay in Methamphetamine Use Disorder Individuals:Delayed Shift From Ambiguity to Risk
Hyung Do KIM ; Yang-Tae KIM ; Sang Soo SEO
Journal of the Korean Society of Biological Therapies in Psychiatry 2024;30(3):76-85
Objectives:
The aim of this study was to investigate how impaired decision-making, hypersensitivity to reward, and executive dysfunction in individuals with methamphetamine use disorder affect their ability to make decisions under uncertain conditions.
Methods:
We conducted a study with 33 patients diagnosed with methamphetamine use disorder and 33 healthy individuals. Three tasks were administered: the Iowa Gambling Task (IGT), Game of Dice Task (GDT), and Wisconsin Card Sorting Test (WCST). We then analyzed the participants’ performance on these tasks and calculated the correlations between them.
Results:
Patients with methamphetamine use disorder performed poorly on all three tasks compared to the healthy individuals. Furthermore, the correlations between performances on the GDT and the later trials of the IGT were delayed in the methamphetamine use disorder group compared to the healthy group. A strong correlations were also observed between performances on the earlier trials of the IGT and the WCST in the patient group.
Conclusions
These findings suggest that executive dysfunction in individuals with methamphetamine use disorder impairs their ability to accurately estimate the probabilities of different choices. Consequently, this impairment leads to a delayed transition from uncertain to risky decisions in the IGT. The study sheds light on the neuropsychological factors that contribute to impaired decision-making under uncertainty in individuals with methamphetamine use disorder.
8.Factors Influencing Self-Perceived Depression in Adolescents During COVID-19 Pandemic
Ju-Yeon LEE ; Honey KIM ; Jae-Min KIM ; Il-Seon SHIN ; Sung-Wan KIM
Journal of the Korean Society of Biological Therapies in Psychiatry 2024;30(3):61-68
Objectives:
This study was performed to identify factors associated with self-perceived depression among Korean adolescents during the coronavirus disease-2019 (COVID-19) pandemic.
Methods:
A total of 1,710 middle and high school students (54.7% boys, 45.3% girls) participated in a cross-sectional survey. The self-administered questionnaire included items assessing the changes in perceived depression and daily life patterns during the COVID-19 pandemic. Other questionnaires included sociodemographic data, three item version of the UCLA Loneliness Scale, Gratitude Questionnaire-6, and Big Five Inventory-10. Multivariable logistic regression was used to examine the factors associated with increased perceived depression during COVID-19 pandemic.
Results:
The prevalence rate of perceived depression was 18.4%. The multivariate logistic regression analysis revealed that high loneliness, neuroticism, decreased social relationships, increased familial conflict, increased internet using time, irregular meal pattern, and high perceived academic stress were significantly associated with perceived depression.
Conclusions
Our findings suggest that interventions aimed at coping with stress and regulate perceived depression due to sudden life style changes are necessary for adolescents, as such a global situation like COVID-19 pandemic could be prolonged or repeated.
9.Social Decision Making in Methamphetamine Users Using Ultimatum Game and Dictator Game
Jin Wook BAE ; Yang-Tae KIM ; Sang Soo SEO
Journal of the Korean Society of Biological Therapies in Psychiatry 2024;30(3):86-94
Objectives:
This study aimed to compare social decision-making between healthy controls and methamphetamine users using ultimatum game (UG) and dictator game (DG). In addition, the purpose of this study was to identify the effect of personality factors on social decision-making.
Methods:
The study included 39 methamphetamine users from a drug abuse center and a probation office, as well as 46 individuals in the control group. The UG and DG were conducted, where participants played the roles of proposers and responders. Also The Korean version of the Personality Factor Scale was used to assess personality factors among methamphetamine users.
Results:
The results showed that methamphetamine users had significantly lower acceptance rates compared to the control group in all proposed ratios in the UG. Additionally, the proposed amount of money (South Korean Won, KRW) in the DG were higher for methamphetamine users when the proposer had a happy facial expression and lower when the proposer had an angry facial expression. In addition, methamphtetamine users, who are more neurotic, had lower acceptance rates, but offeres more money when acting as the proposer.
Conclusions
The findings suggest that methamphetamine users exhibit lower acceptance rates in social decision-making tasks, indicating a conflict between self-interest and rejecting unfair offers. The study highlights the importance of considering social decision-making in the treatment and rehabilitation of methamphetamine users to address social maladjustment factors.
10.Effectiveness of Aripiprazole Long-Acting Injection in Schizophrenia Patients Undergoing Antipsychotic Combination Therapy: A Retrospective Observational Study
Je Young SEO ; Won Tan BYUN ; Se Hoon KIM ; Sae Han JOO ; Il Geun JUNG ; Tae Hyoung PARK ; Young Min PARK
Journal of the Korean Society of Biological Therapies in Psychiatry 2024;30(3):95-102
Objectives:
The aim of this study was to evaluate the effectiveness of aripiprazole long-acting injection in patients with schizophrenia undergoing antipsychotics combination therapy.
Methods:
We conducted a retrospective analysis using electronic medical records of patients with schizophrenia who initiated aripiprazole long-acting injectable and were treated with antipsychotics combination therapy. These patients were either admitted to a psychiatric hospital or treated as outpatients between June, 2019 and December, 2019.
Results:
Seventeen patients met the inclusion criteria. The mean number of antipsychotics significantly decreased from 2.53 use to 1.81 at month 12 (p=0.018). Total antipsychotics olanzapine equivalent dose significantly decreased from 46.96 to 27.54 at month 12 (p=0.005). The number of combined medications including antidepressants, mood stabilizers, anxiolytics, and anticholinergics did not significantly change. Both the Positive and Negative Syndrome Scale (PANSS) score and The Global Assessment of Functioning (GAF) score significantly improved until month 24 (p=0.004, 0.038; respectively).
Conclusions
This observational study confirmed that aripiprazole long-acting injection is an effective treatment option for patients with schizophrenia undergoing antipsychotic combination therapy. Well-controlled clinical trials are necessary in the near future.

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