We reviewed the clinical features, prevalence, pathophysiology, and prevention and treatment of delirium in patients with coronavirus disease of 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19, has neurotropic properties, and can penetrate the central nervous system and affect brain neurons. These characteristics may explain the fact that COVID-19 patients may be particularly susceptible to delirium. COVID-19 delirium occurred more frequently in intensive care unit and emergency room settings. Patients with neurologic disorders and the elderly were more vulnerable to delirium. Clinical symptoms of COVID-19 delirium may manifest as a hyper/hypoactive type. Prevention and treatment appear to be similar to conventional treatment strategies. And the patient’s feeling of isolation due to social distancing and a highly intensive labor force of medical personnel must be overcome. Melatonin, alpha-2 agonist, antipsychotics, and valproic acid have been recommended for the treatment of delirium symptoms. However, this article did not go through a systematic literature review.

Objectives: In this study, the clinical characteristics of OSA patients and the quality of life before and after CPAP use were compared to determine the degree of improvement in quality of life according to CPAP use. Methods: Age, sex, height, weight, body mass index, Epworth Sleepiness Scale, Modified Mallampatti Score, Montreal Cognitive Assessment-Korean, and Pittsburgh Sleep Quality Index were compared between men and women through medical records. To understand the degree of improvement in quality of life resulting from use of CPAP, a personal telephone call was made to compare the VAS scores for quality of life before and after CPAP use. Results: In height (HT) (Z = -4.525, p< 0.001), weight (BW) (Z = -2.844, p < 0.05), sleep quality (PSQI) (Z = -2.671, p < 0.05), and arousal index (AI) (Z = -2.105, p < 0.05), there was a difference between men and women (p < 0.05). There was no difference in the remaining variables. Cross-analysis (Chi-square test) confirmed a difference between severity and sex of OSA. It has been found that there is no statistically significant order in size according to level-specific severity of OSA for PreCPAP QOL, PostCPAP QOL, CPAPUse Months, and CPAP4Hr/d (%) (p > 0.05). The difference between AHI before and after CPAP was 36.48 ± 21.54 (t = 11.609, p < 0.001) and the difference between QOL before and after CPAP was –25.43 ± 22.06 (t = -7.901,p < 0.001), both of which were significant (p < 0.001). Conclusion Among OSA patients, there were differences in height (HT), weight (BW), sleep quality (PSQI), arousal index (AI), and severity of OSA between men and women, but the quality of life before and after CPAP was different. However, there was no difference between men and women in quality of life before and after CPAP. In addition, quality of life in OSA patients improved after using CPAP

Objectives: In this study, the clinical characteristics of OSA patients and the quality of life before and after CPAP use were compared to determine the degree of improvement in quality of life according to CPAP use. Methods: Age, sex, height, weight, body mass index, Epworth Sleepiness Scale, Modified Mallampatti Score, Montreal Cognitive Assessment-Korean, and Pittsburgh Sleep Quality Index were compared between men and women through medical records. To understand the degree of improvement in quality of life resulting from use of CPAP, a personal telephone call was made to compare the VAS scores for quality of life before and after CPAP use. Results: In height (HT) (Z = -4.525, p< 0.001), weight (BW) (Z = -2.844, p < 0.05), sleep quality (PSQI) (Z = -2.671, p < 0.05), and arousal index (AI) (Z = -2.105, p < 0.05), there was a difference between men and women (p < 0.05). There was no difference in the remaining variables. Cross-analysis (Chi-square test) confirmed a difference between severity and sex of OSA. It has been found that there is no statistically significant order in size according to level-specific severity of OSA for PreCPAP QOL, PostCPAP QOL, CPAPUse Months, and CPAP4Hr/d (%) (p > 0.05). The difference between AHI before and after CPAP was 36.48 ± 21.54 (t = 11.609, p < 0.001) and the difference between QOL before and after CPAP was –25.43 ± 22.06 (t = -7.901,p < 0.001), both of which were significant (p < 0.001). Conclusion Among OSA patients, there were differences in height (HT), weight (BW), sleep quality (PSQI), arousal index (AI), and severity of OSA between men and women, but the quality of life before and after CPAP was different. However, there was no difference between men and women in quality of life before and after CPAP. In addition, quality of life in OSA patients improved after using CPAP

OBJECTIVES: Healthy sleep is important and can have a positive effect on resilience. The aim of the present study was to compare the differences in resilience between two group nurses in rotating shift and daytime fixed work schedules and to investigate stress perception, coping factors, social and psychological health, and sleep factors that may affect resilience. METHODS: A total of 400 female nurses having rotating shift and daytime fixed work schedules at two hospitals was surveyed from June 12, 2017 to June 12, 2018. All participants completed perceived stress scale (PSS), stress coping short form (Brief COPE), psycho-social wellbeing Index short form (PWI-SF) or general health questionnaire-18 (GHQ-18), center for epidemiologic studies depression scale (CES-D), STAI-X-1 in state-trait anxiety inventory (STAI), Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), insomnia severity index (ISI), Conner Davidson resilience scale (CD-RISC). Independent t-test, paired t-test, Pearson correlation analysis, and multiple regression analysis were applied to the results of the final 373 questionnaires of 400 nurses in two general hospitals. RESULTS: Comparing the variable statistics between the two groups of rotating shift and daytime fixed work nurses, showed statistically significant differences in all variables except perceived stress, sleep quality, and daytime sleepiness. Factors that had a significant correlation with resilience were stress coping strategies, depression, and insomnia severity (p < 0.001). In multiple regression analysis, larger positive reframing1 (β = 0.206, p < 0.001), severe less depression (β = −3.45, p < 0.001), and higher psychosocial health (β = 0.193, p < 0.001). As acceptance coping2 increased (β = 0.129, p < 0.05), as daytime sleepiness decreased (β = −1.17, p < 0.05), and as active coping2 increased (β = 0.118, p < 0.05), as the positive reframing2 increases (β = 0.110, p < 0.05), the resilience increased. CONCLUSION This study, it was found that resilience was higher in daytime fixed workers than in shift workers. In addition, specific stress coping strategies, psycho-social health, sleep, and depression factors were associated with resilience.

OBJECTIVES: This study aimed to analyze causality among sleep apnea, depression and cognitive function in patients with obstructive sleep apnea. METHODS: We reviewed the medical records of 105 patients with sleep apnea and snoring who underwent overnight polysomnography (PSG). We analyzed various biological data, sleep variables (sleep duration and percentage) and respiratory variables [arousal index (AI), periodic leg movement index (PLM index), snoring Index (SI), mean SpO2, minimum SpO2, apnea-hypopnea index (AHI), and respiratory disturbance index (RDI)]. We also analyzed various data by sleep, cognition, and mood related scales: Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), snoring index by scale (SIS), Montreal Cognitive Assessment-Korean (Moca-K), Mini-mental State Examination-Korean (MMSE-K), clinical dementia rating (CDR), and Beck Depression Inventory (BDI). We analyzed causation among sleep, and respiratory, mood, and cognition related scales in obstructive sleep apnea patients. We analyzed the mediating effects of depression on sleep apnea patient cognition. RESULTS: As Duration N1 increased and Total sleep time (TST) decreased, MOCA-K showed negative causality (p < 0.01). As BDI and supine RDI increased, causality was negatively related to MOCA-K (p < 0.01). As PSQI (p < 0.001) and SIS (p < 0.01) increased and as MMSE-K (p < 0.01) decreased, causality was positively related to BDI. BDI was found to mediate the effect of age on MOCA-K in patients with obstructive sleep apnea. CONCLUSION: Duration N1, total sleep time, BDI, and supine RDI were associated with cognitive function in obstructive sleep apnea patients. Depression measured by BDI partially mediated cognitive decline in obstructive sleep apnea patients.
Cognition* ; Dementia ; Depression* ; Humans ; Leg ; Medical Records ; Negotiating* ; Polysomnography ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive ; Snoring ; Weights and Measures

OBJECTIVES: Some paper claim thyroidectomy decreases snoring and sleep apnea symptoms and the opposite. The aim of this study is to evaluate and compare the effects of sleep apnea and snoring by total thyroidectomy and radioactive iodine (RI) therapy. METHODS: A total of 88 patients who underwent total thyroidectomy and RI therapy for thyroid cancer in the outpatient clinic of the department of surgery of a general hospital were recruited. Interviewers completed their demographic data, past medical history, and data on total thyroidectomy and sleep apnea with snoring, and also preoperative and postoperative Pittsburgh Sleep Quality Index (PSQI), preoperative and postoperative Epworth Sleepiness Scale (ESS), preoperative and postoperative Snoring Index (SI), preoperative and postoperative global life satisfaction (index of well-being) scale, and postoperative Beck Depression Inventory. RESULTS: The Wilcoxon Signed Ranks Test showed PSQI preoperative-postoperative p=0.750, ESS preoperative-postoperative p=0.000, SI preoperative-postoperative p=0.034, life satisfaction preoperative-postoperative p=0.216 (based on negative ranks). CONCLUSION: The above results indicate that snoring and daytime sleepiness increased after total thyroidectomy and RI therapy, suggesting that the patency of upper airway (UA) was reduced or the collapsibility of the UA increased after total thyroidectomy and RI therapy. That is, the above results indicate that sleep apnea and snoring were aggravated after total thyroidectomy and RI therapy.
Ambulatory Care Facilities ; Depression ; Hospitals, General ; Humans ; Iodine* ; Sleep Apnea Syndromes* ; Snoring* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy*

OBJECTIVES: Shift work disorder occurs when you have difficulties adjusting to a work schedule that takes place during a time which most people sleep. Some people may have diverse psychosomatic symptoms, such as sleep problems, depression, anxiety, and headaches even after the shift work schedule ends. The aims of this study are to compare difference of psychosomatic symptoms between rotating shift and daytime working nurse groups. METHODS: Volunteer nurses working in a general hospital were recruited in a general hospital. We collected sociodemographic data. We used questionnaires for headache type, headache frequency, and VAS(Visual Analog Scale) for headache intensity, BDI(Beck depression Inventory) and GSAQ(Global Sleep Assessment Questionnaire). We used Mann-Whitney test and Chi-square test for hypothesis testing. RESULTS: Data collected from 84 women nurses. Rotating shift(N=37) working nurses showed younger, more unmarried, and shorter work periods than daytime working nurses (N=47). Also rotating shift group showed more problems of headache, insomnia, excessive daytime sleepiness, depression and anxiety than daytime group. The above results were statistically significant. CONCLUSIONS: The rotating shift work women nurses produced more headache, insomnia, excessive daytime sleepiness, depression, and anxiety than daytime working ones.
Anxiety ; Appointments and Schedules ; Depression ; Female ; Headache ; Hospitals, General* ; Humans ; Questionnaires ; Single Person ; Sleep Initiation and Maintenance Disorders ; Volunteers

OBJECTIVE: Several studies have reported that ethnic differences influence psychiatric diagnoses. Some previous studies reported that African Americans and Hispanics are diagnosed with schizophrenia spectrum disorders more frequently than Caucasians, and that Caucasians are more likely to be diagnosed with affective disorders than other ethnic groups. We sought to identify associations between sociodemographic factors and psychiatric diagnosis. METHODS: We retrospectively examined the medical records of all psychiatric inpatients (ages over 18 years) treated at Kern county mental hospital (n=2,051) between July 2003 and March 2007 for demographic, clinical information, and discharge diagnoses. RESULTS: African American and Hispanic males were more frequently diagnosed with schizophrenia spectrum disorders than Caucasians, whereas Caucasian females were more frequently diagnosed with affective disorders than females in the other ethnic groups, suggesting that patient ethnicity and gender may influence clinical diagnoses. Demographic variables, that is, a lower education, failure of marriage, homelessness, and low quality insurance, were found to be significantly associated with a diagnosis of schizophrenia spectrum disorders after adjusting for clinical variables. And, the presence of a family psychiatric history, failure of marriage, not-homelessness, and quality insurance were found to be associated with a diagnosis of affective disorders. CONCLUSION: Our results show that these demographic factors, including ethnicity, have effects on diagnoses in psychiatric inpatients. Furthermore, these variables may help prediction of psychiatric diagnoses.
African Americans ; Demography ; Ethnic Groups ; Female ; Hispanic Americans ; Homeless Persons ; Hospitals, Psychiatric ; Humans ; Inpatients ; Insurance ; Male ; Marriage ; Medical Records ; Mental Disorders ; Mood Disorders ; Retrospective Studies ; Schizophrenia

OBJECTIVES: We conduct this study to investigate the common features between Attention Deficit Hyperactivity Disorder(ADHD) and epileptic patients compared to normal control. METHODS: Epileptic patients were recruited from the department of pediatic in Jesus Hospital. ADHD patients were recruited from the department of neuropsychiatry in Jesus Hospital. We excluded mental retardation or brain organic pathology. We use ADHD Diagnostic System and Korean-Child Behavior Checklist(K-CBCL) to assess features of ADHD. Electroencephalogram(EEG) of ADHD, epileptic patients and normal control were analyzed and compared. RESULTS: Compared to normal control group, inattention, reaction time deviation were increased in both ADHD and epilepsy group. EEG abnormalities(control 13.8%, epilepsy 97.1%, ADHD 40%) in three groups were reported. CONCLUSION: There are common features of ADHD and epileptic patients.
Adolescent ; Attention Deficit Disorder with Hyperactivity ; Brain ; Electroencephalography ; Epilepsy ; Humans ; Intellectual Disability ; Neuropsychiatry ; Reaction Time

OBJECTIVES : Paruresis (or Shy bladder syndrome) is characterized by the inability to urinate in the public lavatory. The Paruresis Checklist (PCL) is the only tool that screens for this disorder. The aim of this study was to assess the reliability and validity of the Korean Version of the Paruresis Checklist (K-PCL), and to examine characterstics of this disorder. METHODS : 530 males were enrolled in this study. We administered the K-PCL, the Social Avoidant and Distress scale (SAD), and the Beck Anxiety Inventory (BAI). The Case group included individuals whos PCL score was > or =5. Statistical analyses were performed to compare the BAI and Korea-Social Avoidance and Distress (K-SAD) scores of each group using 2-way ANOVA and Scheffe methods. RESULTS : The K-PCL score ranged from 0 to 6, with a mean 0.75. The Cronbach alpha coefficients of the K-PCL were .72, SAD .74 and BAI .73. A total of 8 males (1.51%) were included in the case group. Comparison of the case and control groups showed a significant difference in BAI scores, but no significant difference in K-SAD scores. CONCLUSION : The K-PCL showed a significant reliability and validity for paruresis. However, our results were not consistent with the notion that paruresis is a special form of social phobia.
Anxiety ; Checklist ; Humans ; Male ; Phobic Disorders ; Reproducibility of Results ; Urinary Bladder