Objective: Early trauma significantly affects the severity of panic disorder (PD) symptoms and suicidal ideation. However, few studies have explored the specific effects of different early trauma subtypes on PD. This study analyzed how childhood trauma subtypes, including general, physical, emotional, and sexual, influence panic and phobia levels and suicidal ideation in adults with PD and healthy controls (HCs). Methods: In total, 455 adults with PD and 149 HCs participated in this study. The independent variables were sociodemographic and clinical variables such as coping strategies and early trauma subtypes from the Early Trauma Inventory Self Report-Short Form. The dependent variables were the Albany Panic and Phobia Questionnaire (APPQ), the Panic Disorder Severity Scale, and the Scale for Suicide Ideation (SSI). Results: Early emotional trauma significantly influenced the APPQ scores, whereas early physical trauma significantly influenced the SSI scores in patients with PD. However, in HCs, only early emotional trauma was significantly associated with the APPQ and SSI scores. Conclusion These findings highlight the influence of early trauma subtypes on the phobic symptom severity of PD and suicidal ideation among patients with PD. Early emotional trauma is associated with the severity of phobic symptoms, whereas early physical trauma is associated with suicidal ideation, suggesting distinct clinical outcomes based on the type of trauma in patients with PD.

Purpose: Despite scientific evidence regarding laparoscopic gastrectomy (LG) for advanced gastric cancer treatment, its application in patients receiving neoadjuvant chemotherapy remains uncertain. Materials and Methods: We used the 2019 Korean Gastric Cancer Association nationwide survey database to extract data from 489 patients with primary gastric cancer who received neoadjuvant chemotherapy. After propensity score matching analysis, we compared the surgical outcomes of 97 patients who underwent LG and 97 patients who underwent open gastrectomy (OG). We investigated the risk factors for postoperative complications using multivariate analysis. Results: The operative time was significantly shorter in the OG group. Patients in the LG group had significantly less blood loss than those in the OG group. Hospital stay and overall postoperative complications were similar between the two groups. The incidence of Clavien– Dindo grade ≥3 complications in the LG group was comparable with that in the OG group (1.03% vs. 4.12%, P=0.215). No statistically significant difference was observed in the number of harvested lymph nodes between the two groups (38.60 vs. 35.79, P=0.182). Multivariate analysis identified body mass index (odds ratio [OR], 1.824; 95% confidence interval [CI], 1.029–3.234; P=0.040) and extent of resection (OR, 3.154; 95% CI, 1.084–9.174; P=0.035) as independent risk factors for overall postoperative complications. Conclusions Using a large nationwide multicenter survey database, we demonstrated that LG and OG had comparable short-term outcomes in patients with gastric cancer who received neoadjuvant chemotherapy.

Objectives: Our study aimed to analyze the demographic and clinical characteristics of children and adolescents during their first visit to psychiatric outpatient departments for the management of suicidal ideation and behavior, and to compare the changes before and in 2012 or later. Methods: This multicenter study was conducted at five university hospitals in a metropolitan area in South Korea. Medical records of patients aged 6–18 years were retrospectively reviewed from January 2009 to December 2016. Patients were analyzed by classifying them into suicidal and non-suicidal groups based on their visit to the hospital for management of suicidal ideation or suicide attempt and other mental problems, respectively. Results: There were differences in the year of visit, diagnosis, education level, and referral sources between patients in the suicidal and non-suicidal groups. Multiple regression analysis was conducted based on the sex, education level, referral by school, and diagnosis of depression in patients in the suicidal group, which revealed significant association. Conclusion Suicide-related problems were significantly associated with the sex, education level, referral by school, and a diagnosis of depression in the patients. A well-connected referral system would be necessary for professional mental health management of high-risk children and adolescents.

Background: Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and depression present with different clinical characteristics compared to those without other psychiatric comorbidities (i.e., ADHD alone). This study aimed to determine the differences in clinical characteristics, complaints, and referral routes between patients with ADHD with and without depression. Methods: The study included 1,231 children and adolescents in Korea. The demographic characteristics, referral routes, and chief complaints were identified and analyzed using the subjects’ electronic medical records of their first outpatient visit. Results: The mean age and proportion of female subjects with depression and ADHD (ADHD-D, n=120) were significantly higher than those of patients with ADHD alone (ADHD-O, n=1,111). Furthermore, referral requests by the caregiver (p=0.037) and patient (p=0.006) were significantly higher in the ADHD-D group. In contrast, referrals via schools (p=0.009) and other medical institutions (p<0.001) were significantly higher in the ADHD-O group. There were more complaints of depression, anxiety, mood dysregulation, suicidal ideation, and self-harm behaviors among the patients in the ADHD-D group. However, complaints of inattention were more common among the patients in the ADHD-O group compared to those in the ADHD-D group (p<0.001). Conclusion This study revealed several differences in the demographic characteristics, referral routes, and chief complaints of the patients and caregivers between patients with ADHD with and without coexisting depression. Further investigations using structured psychiatric diagnostic tools are warranted.

OBJECTIVES: Disrupted integrities of the fornix and stria terminalis have been suggested in schizophrenia. However, very few studies have focused on the fornix and stria terminalis comparing first-episode schizophrenia (FESZ), chronic schizophrenia (CS), and healthy controls (HCs) with the application of diffusion-tensor imaging (DTI) technique. The objective of this study is to compare the connectivity of the fornix and stria terminalis among FESZ, CS, and HCs. METHODS: We included the 44 FESZ patients, 39 CS patients and 20 HCs in this study. Voxel-wise statistical analysis of the fractional anisotropy (FA) data was performed using Tract-Based Spatial Statistics to analyze the connectivity of fornix and stria terminalis. In addition, the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were used to evaluate clinical symptom severities. RESULTS: There were no significant differences between the FESZ, CS, and HCs in age, sex, education years. The SAPS and SANS scores of the schizophrenia groups showed no significant differences. FA values of the right fornix cres/stria terminalis in the CS group were significantly lower than those in FESZ and HCs. There were no significant differences of FA values of the right fornix cres/stria terminalis between the FESZ and the HCs. Pearson correlation analyses revealed that significant correlation between FA values of the right fornix cres/stria terminalies of the the FESZ group and positive, negative symptom scales, and FA values of the right fornix cres/stria terminalis of the CS group and negative symptom scales. CONCLUSIONS: This study shows that FA values of the fornix and stria terminalis in the CS were lower than in the FESZ and the HCs. These results suggest that the fornix and stria terminalis can play a role in pathophysiology of schizophrenia. Thus current study can broaden our understanding of the pathophysiology of schizophrenia.
Anisotropy ; Education ; Fornix, Brain ; Humans ; Schizophrenia ; Septal Nuclei ; Weights and Measures ; White Matter

We examined predictors of suicide attempts in clinically depressed adolescents in Korea and gender differences in suicidal behavior. In total, 106 adolescents diagnosed with depressive disorder were recruited in South Korea. We assessed various variables that might affect suicide attempts, and used a structured interview for the diagnosis of depression and comorbidities and to evaluate suicidality. Demographic and clinical characteristics of the subjects were compared between suicide attempt and non-suicide attempt groups and we examined significant predictors of suicide attempts. Gender differences in suicidal ideation and suicidal behavior were also analyzed. Among 106 depressed participants, 50 (47.2%) adolescents were classified in the suicide attempt group. Generally, the suicide attempt and non-suicide attempt group shared similar clinical characteristics. The suicide attempt group had more females, more major depressive disorder diagnoses, more depressive episodes, and higher suicidal ideation than the non-suicide attempt group. Suicidal ideation was the only significant predictor of suicidal attempt, regardless of gender. Higher suicidal ideation frequency scores and more non-suicidal self-injurious behaviors were shown in the female suicide attempt group than the male suicide attempt group. It is recommended that suicidal ideation be assessed regularly and managed rigorously to decrease suicide risks in depressive adolescents.
Adolescent* ; Comorbidity ; Depression ; Depressive Disorder ; Depressive Disorder, Major ; Diagnosis ; Female ; Humans ; Korea ; Male ; Self-Injurious Behavior ; Suicidal Ideation ; Suicide* ; Suicide, Attempted

OBJECTIVES: The objective of this study was to identify the risky behavior subtypes in adolescents with depression, and the relationship between those subtypes and suicide attempt. METHODS: Ninety adolescents who met the Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria for major depressive disorder, dysthymia, or depressive disorder not otherwise specified participated in the study. Participants were interviewed about suicidal attempts, non-suicidal self-injuries. Smoking, drinking behaviors, and searching for the word "suicide" on the internet, negative life events including bulling-bullied experiences, and history of abuse were also included with questionnaires. RESULTS: The results of cluster analysis showed that four risky behaviors were divided into three clusters : non-risky type, characterized by few risky behaviors ; delinquency type, which was characterized by smoking and drinking ; non-suicidal self-injury type. In non-suicidal self-injury type, percentage of girls was higher and clinical symptoms were more severe than delinquency type. In addition, delinquency type members could be a bully, while non-suicidal self-injury type members could be abused by a family member. Logistic regression analysis showed that both risky behavior subtypes were significant predictors of suicide attempt. CONCLUSION: These results suggest that two types of risky behaviors of depressed adolescents have an effect on the suicide attempts independently. Then, the implications and limitations of the study were discussed and directions for future studies were suggested.
Adolescent* ; Depression* ; Depressive Disorder ; Depressive Disorder, Major ; Drinking ; Drinking Behavior ; Female ; Humans ; Internet ; Logistic Models ; Smoke ; Smoking ; Suicide*

OBJECTIVES: The aim of our study was to investigate association of norepinephrine transporter gene (SLC6A2) polymorphism and side effects of osmotic-release oral system methylphenidate (OROS MPH) in children with attention-deficit hyperactivity disorder (ADHD). METHODS: We recruited drug naive children with ADHD (N=97). We administered OROS MPH by tolerable dosage. At week 8 of treatment, parents completed the Barkley's side effect rating scale. We analyzed two SLC6A2 single nucleotide polymorphisms (SNPs), rs192303 and rs3785143, with blood of subjects. We compared the frequency and severity of each side effect among SLC6A2 genotypes of 2 SNPs. RESULTS: In the analysis of frequency of each side effect, irritability differed according to rs192303 and rs3785143 genotype. In comparisons of severity, talking less and disinterest differed according to rs192303 genotype. In the case of rs3785143, severities of disinterest and irritability were involved with genotype. CONCLUSION: Side effects of OROS MPH showed an association with SLC6A2 genotype.
Child ; Genotype ; Humans ; Methylphenidate* ; Norepinephrine Plasma Membrane Transport Proteins* ; Parents ; Polymorphism, Single Nucleotide

OBJECTIVES: This study aims to investigate possible associations between proneness toward smartphone addiction and certain psychopathological variables to evaluate the psychopathological meaning of smartphone addiction. METHODS: Questionnaires were assigned to 755 adults between September and November 2012. We used the Korean Smartphone Addiction Proneness Scale (SAPS), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Obsessive-Compulsive Inventory-Revised (OCI-R), and the Barratt Impulsivity Scale-11 (BIS-11). Subjects were classified into two groups according to the scores of the SAPS ; the addiction proneness group and the normal-user group. RESULTS: The addiction proneness group had significantly higher scores than the normal-user group in the BDI, BAI, OCI-R, and BIS-11. The scores of the SAPS were positively correlated with the scores of the BDI, BAI, OCI-R, and BIS-11. Using logistic regression analysis, smartphone addiction proneness showed a significant association with BIS-11. CONCLUSIONS: The results of this study suggest that smartphone addiction proneness may be associated with depression, anxiety, obsessive-compulsive symptoms, and impulsivity. Furthermore, impulsivity could be a vulnerability marker for smartphone addiction proneness.
Adult ; Anxiety ; Depression ; Humans ; Impulsive Behavior ; Logistic Models ; Psychopathology* ; Smartphone ; Surveys and Questionnaires

OBJECTIVE: Serotonin-1A receptors (5-HTR1A) is suggested to be involved in the etiology of several psychiatric disorders including panic disorder (PD). A few imaging studies have suggested the alterations of the cingulum bundle in PD. The objective of this study is to examine the structural changes of cingulum related to the 5-HTR1A polymorphism rs6295 in the patients with PD. METHODS: Thirty-two right-handed patients with PD [11 men, 21 women; 40.34+/-13.17 (mean+/-SD) age] who met the diagnostic criteria in Structured Clinical Interview for DSM-IV were examined by means of MRI at 3 Tesla. We divided the patients with PD into CC genotype group and non CC genotype group (GG/CG genotype group) of the 5-HTR1A rs6295 polymorphism to compare the cingulum white matter connectivity. RESULTS: Tract-based spatial statistics showed significantly increased fractional anisotropy (FA) values in cingulate gyrus process of left cingulum in 5-HTR1A CC genotype compared to GG/CG genotype in PD. Significant positive correlations were shown between the Albany Panic and Phobia Questionnaire (APPQ) interoceptive fear subscale scores, the Anxiety Sensitivity Inventory-Revised fear of publicly observable anxiety reaction subscale scores and FA values of cingulate gyrus process of left cingulum in 5-HTR1A rs6295 GG/CG genotype group. In CC genotype group, APPQ total, APPQ agoraphobia subscale and APPQ social phobia subscale scores also showed significant positive correlations with FA values of hippocampal process of right cingulum. CONCLUSION: This preliminary study suggests that 5-HTR1A polymorphism may be associated with the cingulum white matter connectivity in PD.
Agoraphobia ; Anisotropy ; Anxiety ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Genotype ; Gyrus Cinguli ; Humans ; Magnetic Resonance Imaging ; Male ; Neuroimaging ; Panic Disorder* ; Panic* ; Phobic Disorders ; Surveys and Questionnaires