1.Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3
Seon-Cheol PARK ; Kiwon KIM ; Jeongsoo PARK ; Sun CHOI ; Seonhwa LEE ; Seungwon CHO ; Eunkyung KIM ; Tian-Mei SI ; Roy Abraham KALLIVAYALIL ; Andi J. TANRA ; Amir Hossein Jalali NADOUSHAN ; Kok Yoon CHEE ; Afzal JAVED ; Kang SIM ; Pornjira PARIWATCHARAKUL ; Takahiro A. KATO ; Shih-Ku LIN ; Naotaka SHINFUKU ; Norman SARTORIUS
Psychiatry Investigation 2025;22(5):552-563
		                        		
		                        			 Objective:
		                        			The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism. 
		                        		
		                        			Methods:
		                        			We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test. 
		                        		
		                        			Results:
		                        			Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness). 
		                        		
		                        			Conclusion
		                        			This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment. 
		                        		
		                        		
		                        		
		                        	
2.Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3
Seon-Cheol PARK ; Kiwon KIM ; Jeongsoo PARK ; Sun CHOI ; Seonhwa LEE ; Seungwon CHO ; Eunkyung KIM ; Tian-Mei SI ; Roy Abraham KALLIVAYALIL ; Andi J. TANRA ; Amir Hossein Jalali NADOUSHAN ; Kok Yoon CHEE ; Afzal JAVED ; Kang SIM ; Pornjira PARIWATCHARAKUL ; Takahiro A. KATO ; Shih-Ku LIN ; Naotaka SHINFUKU ; Norman SARTORIUS
Psychiatry Investigation 2025;22(5):552-563
		                        		
		                        			 Objective:
		                        			The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism. 
		                        		
		                        			Methods:
		                        			We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test. 
		                        		
		                        			Results:
		                        			Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness). 
		                        		
		                        			Conclusion
		                        			This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment. 
		                        		
		                        		
		                        		
		                        	
3.Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3
Seon-Cheol PARK ; Kiwon KIM ; Jeongsoo PARK ; Sun CHOI ; Seonhwa LEE ; Seungwon CHO ; Eunkyung KIM ; Tian-Mei SI ; Roy Abraham KALLIVAYALIL ; Andi J. TANRA ; Amir Hossein Jalali NADOUSHAN ; Kok Yoon CHEE ; Afzal JAVED ; Kang SIM ; Pornjira PARIWATCHARAKUL ; Takahiro A. KATO ; Shih-Ku LIN ; Naotaka SHINFUKU ; Norman SARTORIUS
Psychiatry Investigation 2025;22(5):552-563
		                        		
		                        			 Objective:
		                        			The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism. 
		                        		
		                        			Methods:
		                        			We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test. 
		                        		
		                        			Results:
		                        			Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness). 
		                        		
		                        			Conclusion
		                        			This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment. 
		                        		
		                        		
		                        		
		                        	
4.Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3
Seon-Cheol PARK ; Kiwon KIM ; Jeongsoo PARK ; Sun CHOI ; Seonhwa LEE ; Seungwon CHO ; Eunkyung KIM ; Tian-Mei SI ; Roy Abraham KALLIVAYALIL ; Andi J. TANRA ; Amir Hossein Jalali NADOUSHAN ; Kok Yoon CHEE ; Afzal JAVED ; Kang SIM ; Pornjira PARIWATCHARAKUL ; Takahiro A. KATO ; Shih-Ku LIN ; Naotaka SHINFUKU ; Norman SARTORIUS
Psychiatry Investigation 2025;22(5):552-563
		                        		
		                        			 Objective:
		                        			The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism. 
		                        		
		                        			Methods:
		                        			We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test. 
		                        		
		                        			Results:
		                        			Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness). 
		                        		
		                        			Conclusion
		                        			This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment. 
		                        		
		                        		
		                        		
		                        	
5.Network Structure of Depression and Anxiety Symptoms in Older Asian Patients With Depressive Disorders: Findings From REAP-AD3
Seon-Cheol PARK ; Kiwon KIM ; Jeongsoo PARK ; Sun CHOI ; Seonhwa LEE ; Seungwon CHO ; Eunkyung KIM ; Tian-Mei SI ; Roy Abraham KALLIVAYALIL ; Andi J. TANRA ; Amir Hossein Jalali NADOUSHAN ; Kok Yoon CHEE ; Afzal JAVED ; Kang SIM ; Pornjira PARIWATCHARAKUL ; Takahiro A. KATO ; Shih-Ku LIN ; Naotaka SHINFUKU ; Norman SARTORIUS
Psychiatry Investigation 2025;22(5):552-563
		                        		
		                        			 Objective:
		                        			The clinical presentation of depressive disorders might be influenced by age, and its diagnosis and treatment can be affected by ageism-related bias. A network analysis can reveal symptom patterns unrecognized by the reductionistic approach. Therefore, this study explores the network structure of depression and anxiety symptoms in older Asian patients with depressive disorders and examines age-related differences in the context of ageism. 
		                        		
		                        			Methods:
		                        			We used data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 study and included 2,785 psychiatric patients from 11 Asian countries. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7. Network analyses were conducted to identify symptom interconnections and centrality among older (>65 years), middle-aged (35–64 years), and young (18–34 years) adult groups. The network structures were also compared using a network comparison test. 
		                        		
		                        			Results:
		                        			Depressed mood was the most central symptom across all age groups. Network comparisons revealed no significant structural differences among the three age groups, despite several variations in terms of global strength. The network structure of the older group was characterized by strong interconnections between somatic symptoms (insomnia-energy) and core depressive symptoms (little interest or pleasure-feelings of hopelessness). 
		                        		
		                        			Conclusion
		                        			This study reveals that the network structures of depression and anxiety symptoms have relatively consistent interconnections across age groups, despite subtle age-based differences. Specifically, older adults tend to present anxiety and depression symptoms as physical complaints. These findings challenge ageist stereotypes and advocate for inclusive, age-neutral approaches to treatment. 
		                        		
		                        		
		                        		
		                        	
6.Clinical Characteristics of Bipolar Disorder Patients with Mood Stabilizer-Induced Cognitive Side Effects findings from the REAP-BD Survey in Korea
Hihyun SHIN ; Jin Hee CHOI ; Hyungseok SO ; Hayun CHOI ; Yong Chon PARK ; Chay Hoon TAN ; Shih-ku LIN ; Naotaka SHINFUKU ; Seon-Cheol PARK ; Kiwon KIM
Journal of Korean Neuropsychiatric Association 2020;59(3):277-284
		                        		
		                        			 Methods:
		                        			This study analyzed 350 Korean adults who were diagnosed with bipolar disorder and prescribed mood-stabilizing drugs. The patients were divided into two groups—patients who experienced cognitive side effects and those who did not experience cognitive side effects.We also compared the demographic and clinical characteristics between both groups. 
		                        		
		                        			Results:
		                        			The number of patients with an untreated illness longer than 1 year was higher in the group of patients who experienced cognitive side effects compared to the group of patients who did not experience cognitive side effects. Further, the number of patients with manic symptoms at onset was higher in the group of patients who experienced cognitive side effects compared to the group of patients who did not experience cognitive side effects. In addition, the proportion of patients in remission was higher in the group of patients who experienced cognitive side effects compared to the group of patients who experienced no cognitive side effects. However, there was no significant difference regarding the type of mood stabilizer used between the groups. On the other hand, more people experienced cognitive side effects as the valproic acid dosage increased. 
		                        		
		                        			Conclusion
		                        			Our findings suggest that there are clinical and demographic differences between people who experienced cognitive side effects and those who did not experience cognitive side effects due to prescription of mood stabilizers. 
		                        		
		                        		
		                        		
		                        	
7.Examining Patterns of Polypharmacy in Bipolar Disorder: Findings from the REAP-BD, Korea
Kiwon KIM ; Hyunju YANG ; Euihyeon NA ; Hoseon LEE ; Ok Jin JANG ; Hyung Jun YOON ; Hong Seok OH ; Byung Joo HAM ; Seon Cheol PARK ; Shih Ku LIN ; Chay Hoon TAN ; Naotaka SHINFUKU ; Yong Chon PARK
Psychiatry Investigation 2019;16(5):397-402
		                        		
		                        			
		                        			Based on Korean data from the Research on Asian Psychotropic Prescription Pattern for Bipolar Disorder, this study tried to present prescription patterns in biopolar disorder (BD) and its associated clinical features. Based on the information obtained from the study with structured questions, the tendency of prescription pattern was studied and analyzed. Polypharmacy was predominant, including simple polypharmacy in 51.1% and complex polypharmacy in 34.2% of patients. Subjects associated with simple or complex polypharmacy were significantly younger, had higher inpatient settings, a larger portion of onset with manic episode, a shorter duration of untreated illness, a shorter duration of current episode, were more overweight, used less antidepressants and used more anxiolytics. These findings can suggest higher polypharmacy rate in more severe BD and highlight the necessity of monitoring the weight of subjects with polypharmacy.
		                        		
		                        		
		                        		
		                        			Anti-Anxiety Agents
		                        			;
		                        		
		                        			Antidepressive Agents
		                        			;
		                        		
		                        			Asian Continental Ancestry Group
		                        			;
		                        		
		                        			Bipolar Disorder
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Inpatients
		                        			;
		                        		
		                        			Korea
		                        			;
		                        		
		                        			Overweight
		                        			;
		                        		
		                        			Polypharmacy
		                        			;
		                        		
		                        			Prescriptions
		                        			
		                        		
		                        	
8.Clinical Characteristics and Psychotropic Drug Prescription Patterns of Bipolar Disorder Patients with a History of Suicidal Attempts: Findings from the REAP-BD, Korea
Seon Cheol PARK ; Kiwon KIM ; Ok Jin JANG ; Seung Gon KIM ; Jung Goo LEE ; Joon Hyuk PARK ; Joonho CHOI ; Dong Woo LEE ; Shih Ku LIN ; Chay Hoon TAN ; Naotaka SHINFUKU ; Yong Chon PARK
Psychiatry Investigation 2019;16(6):459-463
		                        		
		                        			
		                        			Our study aimed to analyze the clinical characteristics and psychotropic prescription patterns of a history of suicide attempts in South Koreans with bipolar disorder (BD), by using only Korean data from the Research on Asian Psychotropic Prescription Pattern for Bipolar disorder. The patterns of clinical characteristics and psychotropic drug use were compared among 53 patients with a history of suicide attempts and 297 without this history; the potential effects of confounding variables were adjusted with binary logistic analyses for discrete variables and analyses of covariance for continuous variables. After adjusting the effects of age, sex, duration of illness, and enrollment as an outpatient, patients with a history of suicide attempts were characterized by a significantly more prevalent depressive episode, lower prevalent remission state, lower levels of hemoglobin, and more use of antidepressants, anxiolytics, and hypnotics compared to those without lifetime suicide attempt. The inability to plan goal-directed behavior may be an intervening factor in the relationship between suicide attempts and depression in BD. Relatively low hemoglobin levels can be associated with manic episodes in patients with a history of suicide attempts and the use of antidepressants, anxiolytics, or hypnotics can be associated with suicide attempts in BD patients.
		                        		
		                        		
		                        		
		                        			Anti-Anxiety Agents
		                        			;
		                        		
		                        			Antidepressive Agents
		                        			;
		                        		
		                        			Asian Continental Ancestry Group
		                        			;
		                        		
		                        			Bipolar Disorder
		                        			;
		                        		
		                        			Confounding Factors (Epidemiology)
		                        			;
		                        		
		                        			Depression
		                        			;
		                        		
		                        			Drug Prescriptions
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Hypnotics and Sedatives
		                        			;
		                        		
		                        			Korea
		                        			;
		                        		
		                        			Outpatients
		                        			;
		                        		
		                        			Prescriptions
		                        			;
		                        		
		                        			Suicide
		                        			
		                        		
		                        	
9.Effect of Doctor and Device Manager on Adherence with Positive Airway Pressure Therapy in Obstructive Sleep Apnea Patients.
Seon Lin KIM ; Ji A KIM ; Deok Soo KIM ; Min Gyu JO ; Sung Dong KIM ; Kyu Sup CHO
Journal of Rhinology 2018;25(1):26-31
		                        		
		                        			
		                        			BACKGROUND AND OBJECTIVES: Although many studies have assessed factors related to adherence of PAP therapy, there were no studies about factors related to doctors or device managers. The purpose of this study was to investigate the relationship between PAP therapy adherence and doctor or device manager. SUBJECTS AND METHODS: Between February 2013 and June 2015, 163 patients newly diagnosed with moderate to severe OSA in one of five hospitals were enrolled in this study. All patients received 4 weeks of PAP treatment with intervention consisting of mechanical support and motivation by doctor and device manager. Data from the PAP device were obtained following a minimum of an initial 30 days, with adherence defined as >4 h/night on 70% of nights. RESULTS: After 30 days, total adherence rate to PAP therapy was 35.6% (n=58). The adherence rate of device manager ① was 26.3% (31/118), and that of device manager ② was 60% (27/45), and there was statistically significant difference between the two device managers. Furthermore, there were statistically significant differences in the adherence to PAP therapy ranging from 85.6% to 0.0% according to doctor. CONCLUSION: Our study demonstrates that the device manager and doctor may be important factors for good adherence to PAP therapy in patients with OSA.
		                        		
		                        		
		                        		
		                        			Continuous Positive Airway Pressure
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Motivation
		                        			;
		                        		
		                        			Patient Compliance
		                        			;
		                        		
		                        			Sleep Apnea, Obstructive*
		                        			
		                        		
		                        	
10.The Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Markers for Prognosis in Idiopathic Sudden Sensorineural Hearing Loss.
Keun Ik YI ; Se Joon OH ; Sung Won CHOI ; Seon Lin KIM ; Soo Keun KONG ; Eui Kyung GOH
Korean Journal of Otolaryngology - Head and Neck Surgery 2018;61(7):333-340
		                        		
		                        			
		                        			BACKGROUND AND OBJECTIVES: The cause of idiopathic sudden sensorineural hearing loss (ISSNHL) is still unclear, but recently, chronic inflammation and thrombosis have received attention. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are some of the markers that show the state of inflammation and ischemia, which are measured routinely in the complete blood cell count (CBC) test. The aim of this study were to investigate the relevance of NLR and PLR with ISSNHL. SUBJECTS AND METHOD: Enrolled in our retrospective analysis were 103 patients diagnosed with ISSNHL. Blood samples were taken from the patients and hearing assessments were performed. NLR and PLR were calculated using the CBC results. Then the patients were divided into 4 groups using Sigel's criteria according to their response to the treatment, which were again classified two groups, the “recovered” and “unrecovered” group. RESULTS: NLR, PLR, and neutrophil values of the unrecovered group were significantly higher than the recovered group (p=0.002, p=0.009, and p=0.038, respectively). On the other hand, lymphocyte values were significantly higher in the recovered group (p=0.007). After adjustment in a multivariate logistic regression analysis, NLR was associated with the recovery of ISSNHL (Odds ratio=1.290, p=0.042). In addition, NLR and PLR values were also significantly different between the groups classified by the Sigel's criteria (p=0.009 and p=0.029, respectively). CONCLUSION: PLR values may be useful in predicting hearing recovery after treatment in patients with ISSNH. It is also expected to be a potential marker for predicting the prognosis and determining further treatment options.
		                        		
		                        		
		                        		
		                        			Biomarkers
		                        			;
		                        		
		                        			Blood Cell Count
		                        			;
		                        		
		                        			Hand
		                        			;
		                        		
		                        			Hearing
		                        			;
		                        		
		                        			Hearing Loss, Sensorineural*
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Inflammation
		                        			;
		                        		
		                        			Ischemia
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Lymphocytes
		                        			;
		                        		
		                        			Methods
		                        			;
		                        		
		                        			Neutrophils
		                        			;
		                        		
		                        			Prognosis*
		                        			;
		                        		
		                        			Retrospective Studies
		                        			;
		                        		
		                        			Thrombosis
		                        			
		                        		
		                        	
            
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