Objective: The Children in Disaster: Evaluation and Recovery (CIDER) program in Korea was developed to treat children and adolescents exposed to trauma. This study aimed to demonstrate the effectiveness of the CIDER through a comparison with controls. Methods: A total of 85 participants consisted of the intervention group (n=41) and control group (n=44). We assessed the changes in trauma-related symptoms, depression, anxiety, and improvements in quality of life before and after the intervention. Results: In total, bullying and school violence (44.7%) were the most common trauma, followed by sexual abuse (17.6%). Acute stress disorder and post-traumatic stress disorder (PTSD) accounted for 41.2%, and attention-deficit/hyperactivity disorder (ADHD) and developmental disorder were the most common comorbidities (51.8%). The symptoms of trauma, depression, anxiety, and quality of life improved significantly in the intervention group, while the control group did not show significant changes. Conclusion Compared with the control group, the CIDER improved symptoms and quality of life in children and adolescents who had experienced trauma. The CIDER program was practical and easy to apply, even for different ages, types of traumas, and comorbidities.

Objective: We aimed to identify the expectations and preferences for medication and medical decision-making in patients with major psychiatric disorders. Methods: A survey was conducted among patients with major psychiatric disorders who visited psychiatric outpatient clinics at 15 hospitals between 2016 and 2018 in Korea. The survey consisted of 12 questions about demographic variables and opinions on their expectations for medication, important medical decision-makers, and preferred drug type. The most preferred value in each category in the total population was identified, and differences in the preference ratio of each item among the disease groups were compared. Results: A total of 707 participants were surveyed. In the total population, patients reported high efficacy (44.01%±21.44%) as the main wish for medication, themselves (37.39%±22.57%) and a doctor (35.27%±22.88%) as the main decision makers, and tablet/capsule (36.16%±30.69%) as the preferred type of drug. In the depressive disorders group, the preference ratio of high efficacy was significantly lower, and the preference ratio of a small amount was significantly higher than that of the psychotic disorder and bipolar disorder groups. The preference ratio of a doctor as an important decision maker in the bipolar disorder group was higher compared to the other groups. Conclusion This study revealed the preference for medications and showed differences among patients with psychiatric disorders. Providing personalized medicine that considers a patient’s preference for the drug may contribute to the improvement of drug compliance and outcomes.

OBJECTIVES: The present study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health service utilization through a comparative analysis of nationwide data regarding inpatient care users, outpatient visits, emergency department (ED) visits, and admissions via the ED before and during the pandemic. METHODS: Data from approximately 350,000 Koreans diagnosed with mental illness were analyzed in terms of hospitalization, outpatient visits, and ED visits between January 2018 and June 2021. An interrupted time series analysis was conducted to determine the significance of changes in mental health service utilization indicators. RESULTS: The number of hospital admissions per patient decreased by 1.2% at the start of the pandemic and 0.7% afterward. The length of hospital stay increased by 1.8% at the outbreak of the pandemic, and then decreased by 20.2%. Although the number of outpatients increased, the number of outpatient visits per patient decreased; the number of outpatient visits for schizophrenia (3.4%) and bipolar disorder (3.5%) significantly decreased immediately post-outbreak. The number of ED visits per patient decreased both immediately post-outbreak and afterward, and ED visits for schizophrenia (19.2%), bipolar disorder (22.3%), and depression (17.4%) decreased significantly immediately post-outbreak. Admissions via the ED did not show a significant change immediately post-outbreak. CONCLUSIONS Mental health service utilization increased during the pandemic, but medical service use decreased overall, with a particularly significant decrease in ED utilization. As the pandemic worsened, the decline in outpatient visits became more pronounced among those with severe mental illness.

Objective: Research on neural correlates in the prefrontal cortex (PFC) associated with self-injurious behavior has mainly been performed in adults. However, studies on adolescents are scarce. We aimed to investigate the activation and connectivity of the PFC between adolescents with self-injurious behavior (ASI) and psychiatric controls (PC) using functional near-infrared spectroscopy (fNIRS). Methods: We used an emotion recognition task during fNIRS to assess 37 adolescents (23 with self-injurious behavior and 14 PC) between June 2020 and October 2021 and compared connectivity and activation between the two groups. We also measured adverse childhood events (ACE, Adverse Childhood Experiences) and performed a correlation analysis of channel activation according to ACE total scores. Results: The difference in activation between the groups was not statistically significant. The connectivity of channel 6 was statistically significant. The interaction between channel 6 and the ACE total score showed statistical significance between the two groups(t[33] -2.61; p=0.014). The ASI group showed a negative correlation with the total ACE score. Conclusion This is the first study to investigate PFC connectivity using fNIRS in ASI. It has the implication of a novel attempt with a practically useful tool to uncover neurobiological differences among Korean adolescents.

Objective: The economic hardship brought by the coronavirus disease-2019 (COVID-2019) pandemic has caused mental health problems among people of different socioeconomic status (SES). As social support helps to buffer these problems, we investigated the association between job loss related to COVID-19 and depression, anxiety, and suicidal thoughts; the differences in the effects according to SES; and the mediating effects of social support. Methods: The effects of COVID-19-related job loss on depression, anxiety, and suicidal thoughts among 1,364 people were investigated through semi-structured and self-administered questionnaires: Patient Health Questionnaire–9, General Anxiety Disorder–7, and the Functional Social Support Questionnaire. Logistic regression and subgroup analyses were performed to assess the association between job loss and mental health status, and the moderating effects of income and educational levels. Moreover, the mediating effects of perceived social support on the association between job loss and depression, anxiety, and suicidal thoughts were analyzed. Results: COVID-19-related job loss increased the risk of depression and suicidal thoughts. Adults with lower income and education level were at higher risk of depression, anxiety, and suicidal thoughts; perceived social support level had significant mediating effects on the association between job loss and depression/anxiety; and income level had significant moderating effects on this mediating pathway. Conclusion COVID-19-related job loss were likely to be significantly associated with negative mental health outcomes, especially among individuals with low income and education levels. As social support had buffering effects on such outcomes, related government policies in cooperation with the governance of communities and stakeholders must be prepared.

Objectives: This study aimed to identify the psychiatric comorbidity status of adult patients diagnosed with attention-deficit hyperactivity disorder (ADHD) and determine the impact of comorbidities on neuropsychological outcomes in ADHD. Methods: The study participants were 124 adult patients with ADHD. Clinical psychiatric assessments were performed by two boardcertified psychiatrists in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. All participants were assessed using the Mini-International Neuropsychiatric Interview Plus version 5.0.0 to evaluate comorbidities. After screening, neuropsychological outcomes were assessed using the Comprehensive Attention Test (CAT) and the Korean version of the Wechsler Adult Intelligence Scale, Fourth Edition (K-WAIS-IV). Results: Mood disorders (38.7%) were the most common comorbidity of ADHD, followed by anxiety (18.5%) and substance use disorders (13.7%). The ADHD with comorbidities group showed worse results on the Perceptual Organization Index and Working Memory Index sections of the K-WAIS than the ADHD-alone group (p=0.015 and p=0.024, respectively). In addition, the presence of comorbidities was associated with worse performance on simple visual commission errors in the CAT tests (p=0.024). Conclusion These findings suggest that psychiatric comorbidities are associated with poor neuropsychological outcomes in adult patients with ADHD, highlighting the need to identify comorbidities in these patients.

Objectives: Early detection of developmental issues in infants and necessary intervention are important. To identify the comorbid conditions, a comprehensive evaluation is required. The study’s objectives were to 1) generate scale items by identifying and eliciting concepts relevant to young children (12–71 months) with developmental delays, 2) develop a comprehensive screening tool for developmental delay and comorbid conditions, and 3) assess the tool’s validity and cut-off. Methods: Multidisciplinary experts devised the “Infant Comprehensive Evaluation for Neurodevelopmental Delay (ICEND),” an assessment method that comes in two versions depending on the age of the child: 12–36 months and 37–71 months, through monthly seminars and focused group interviews. The ICEND is composed of three parts: risk factors, resilience factors, and clinical scales. In parts 1 and 2, there were 41 caretakers responded to the questionnaires. Part 3 involved clinicians evaluating ten subscales using 98 and 114 questionnaires for younger and older versions, respectively. The Child Behavior Checklist, Strengths and Difficulties Questionnaire, Infant-Toddler Social Emotional Assessment, and Korean Developmental Screening Test for Infants and Children were employed to analyze concurrent validity with the ICEND. The analyses were performed on both typical and high-risk infants to identify concurrent validity, reliability, and cut-off scores. Results: A total of 296 people participated in the study, with 57 of them being high-risk (19.2%). The Cronbach’s alpha was positive (0.533–0.928). In the majority of domains, the ICEND demonstrated a fair discriminatory ability, with a sensitivity of 0.5–0.7 and specificity 0.7–0.9. Conclusion The ICEND is reliable and valid, indicating its potential as an auxiliary tool for assessing neurodevelopmental delay and comorbid conditions in children aged 12–36 months and 37–71 months.

Objectives: Deliberate self-poisoning (DSP) is the most common suicide method and can be life-threatening. The purpose of this study was to investigate the factors related to the lethality of DSP and the characteristics of the adolescent group. Methods: A retrospective study was conducted on patients who had visited an academic hospital’s regional emergency medical center between 2015 and 2018. The data reviewed through their medical records included sociodemographic factors, clinical variables, and psychiatric treatment. Four groups (Q1–Q4) were categorized by descriptive analysis using the risk-rescue rating scale. Results: A total of 491 patients were enrolled in this study. This study showed that high lethality had statistically significant associations with male sex, older age, admitting suicidal intentions, and the use of herbicides for suicide. Logistic regression analyses showed a significant association between high-lethality and female [odds ratio (OR)=0.50, 95% confidence interval (CI)=0.30–0.81, p=0.01], non-psychiatric drugs (over-the-counter drug: OR=2.49, 95% CI=1.08–5.74, p=0.03; herbicide: OR=8.65, 95% CI=3.91–19.13, p<0.01), and denial of suicide intent (OR=0.28, 95% CI=0.15–0.55, p<0.01). Conclusion This study showed the clinical factors associated with the high lethality of DSP and suggested that efforts were needed to care for and thoroughly examine patients with DSP.

Objective: This study aimed to develop a brief self-report measure of depressive and anxiety symptoms in victims of sexual violence. Methods: The sample, which consisted of 215 victims and 255 healthy controls, was recruited between December 2016 and November 2018 from eight Sunflower Centers. Eligible items were selected from existing scales of depression (CES-DC and CES-D) and anxiety (SAI-C and BAI) symptoms by item-total correlation coefficients and item response theory (IRT) analysis. Internal consistency coefficients were computed and the receiver operating characteristics curve was inspected to assess the validity of the brief scale and determine optimal cutoff scores. Results: The brief scales showed high internal consistency across all age groups. The optimal cutoff score of brief depression scale was 1.5 for children, 2.5 for adolescents, and 2.5 for the adults. That of brief anxiety scale was 8.5, 6.5, and 3.5, respectively. Conclusion The results underscore the need for age-appropriate screening measures of depressive and anxiety symptoms in victims of sexual violence.