• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.74-82
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• 2016

Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.83-93
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• 2016

Objectives : The Center for Epidemiologic Studies Depression scale-Revised is a recently revised scale which has been reported as a valid tool for the assessment of depressive symptoms. It encompasses cardinal symptoms of depression described in the Diagnostic and Statistical Manual of Mental disorders, fourth edition. In this study, we assessed the reliability, validity and psychometric properties of the Korean version of the CESD-R(K-CESD-R). Methods : Forty-eight patients diagnosed as major depressive disorder, dysthymia, depressive disorder NOS according to the DSM-IV criteria using Mini International Neuropsychiatric Interview and 48 healthy controls were enrolled in this study. They were assessed with K-CESD-R, K-MADRS, PHQ-9, KQIDS-SR, STAI to check cross-validation. Statistical analyses were performed using calculation of Cronbach's alpha, Pearson correlation coefficient, Principal Component Analysis, ROC curve and optimal cut-off value. Results : The Cronbach's alpha of K-CESD-R was 0.98. The total score of K-CESD-R revealed significantly high correlations with those of K-MADRS, PHQ-9, KQIDS-SR(r=0.910, 0.966 and 0.920, p<0.001, respectively). Factor analysis showed two factors account for 76.29% of total variance. We suggested the optimal cut-off value of K-CESD-R as 13 according to analysis of the ROC curve which value sensitivity and specificity both equally. Conclusions : These Results showed that the K-CESD-R could be a reliable and valid scale to assess depressive symptoms. The K-CESD-R is expected as a useful and effective tool for screening and measuring depressive symptoms not only in outpatient clinic but also epidemiologic studies.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.28-42
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• 2016

Objectives : The author tried to find out reasons why and how hysteria(and conversion disorder) patient numbers, which were so prevalent even a few decades ago, have decreased and the phenotype of symptoms have changed. Methods : The number of visiting patients diagnosed with conversion disorder and their phenotype of symptoms were investigated through chart reviews in a psychiatric department of a University hospital for the last 12 years. Additionally, the characteristics of conversion disorder patients visiting the emergency room for last 2 years were also reviewed. Those results were compared with previous research results even if it seemed to be an indirect comparisons. The research relied on Briquet P. and Charcot JM's established factors of the vicissitudes of hysteria(and conversion disorder) which has been the framework for more than one hundred and fifty years since hysteria has been investigated. Results : The author found decreased numbers and changes of the phenotype of the hysteria patients(and conversion disorder) over the last several decades. The decreased numbers and changes of the symptoms of those seemed to be partly due to several issues. These issues include the development of the diagnostic techniques to identify organic causes of hysteria, repeated changes to the symptom descriptions and diagnostic classification, changes of the brain nervous functions in response to negative emotions, and the influence of human evolution. Conclusions : The author proposed that the evolutionary brain discord reaction theory explains the causes of disappearance of and changes to symptoms of hysteria(conversion disorder). Most patients with hysteria(conversion disorder) have been diagnosed in the neurological department. For providing more appropriate treatment and minimizing physical disabilities to those patients, psychiatrists should have a major role in cooperating not only with primary care physicians but with neurologists. The term 'hysteria' which had been used long ago should be revived and used as a term to describe diseases such as somatic symptom disorder, functional neurological symptoms, somatization, and somatoform disorders, all of which represent almost the same vague concept as hysteria.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.102-108
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• 2016

Objectives : The deficit of recognition memory has been found as one of the common neurocognitive impairments in patients with schizophrenia. In addition, they were reported to fail to enhance the memory about emotional stimuli. Previous studies have shown that bilateral eye movements enhance the memory retrieval. Therefore, this study was conducted in order to investigate the memory enhancement of bilaterally alternating eye movements in schizophrenic patients. Methods : Twenty one patients with schizophrenia participated in this study. The participants learned faces (angry or neutral faces), and then performed a recognition memory task in relation to the faces after bilateral eye movements and central fixation. Recognition accuracy, response bias, and mean response time to hits were compared and analysed. Two-way repeated measure analysis of variance was performed for statistical analysis. Results : There was a significant effect of bilateral eye movements condition in mean response time(F=5.812, p<0.05) and response bias(F=10.366, p<0.01). Statistically significant interaction effects were not observed between eye movement condition and face emotion type. Conclusions : Irrespective of the emotional difference of facial stimuli, recognition memory processing was more enhanced after bilateral eye movements in patients with schizophrenia. Further study will be needed to investigate the underlying neural mechanism of bilateral eye movements-induced memory enhancement in patients with schizophrenia.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.3-11
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• 2015

Objectives:To determine the influence of parental behaviors on the onset and severity of eating disorders, this study compared aspects of perceived parental styles, according to eating disorder subtypes and age at onset in Korean women with eating disorders. Methods:One hundred and sixty-seven patients with eating disorders[Anorexia Nervosa (AN), N=49; Bulimia Nervosa(BN), N=118] were recruited for this study. Perceived parent behaviors were assessed with Parental Behavior Inventory(PBI) self-rating scale. The study subjects also completed the Eating Disorder Inventory -2 (EDI-2) to assess the severity of eating disorder symptoms. Results:In anorexia nervosa, early onset group(<16 years) reported low paternal affection and high paternal rational expression, low maternal interference than group with age at onset over 16 years. The severity of eating disorder symptoms was negatively associated with mother affection and rational expression in two subtypes of eating disorder(AN and BN). On stepwise regression analysis, paternal affection and maternal over-protection were associated with age of onset only in AN group and maternal affection was associated with the severity of symptoms in both groups of eating disorder. Conclusions:Considering the role of family function and perceived parental styles could help improve the management of eating disorders. These results emphasize the importance of fathers' role in the eating disorder on the age of onset, a relatively unexplored area of eating disorder research. Also, we investigated the importance of mothers' affection on the severity of symptoms.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.57-65
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• 2015

Objectives:Within the normal reproductive cycles of women, dramatic fluctuations of sexual hormones occur in the premenstrual and menopausal periods. In both periods, women are vulnerable to mood disturbances and show several somatic complaints. Based on these common clinical profiles and physiological changes, a relationship between vasomotor symptoms and the premenstrual syndrome has been suggested. However, attempts to establish such a link have yielded inconclusive results. The purpose of this study was to investigate the association between histories of premenstrual syndrome and menopausal vasomotor symptoms within different menopausal stages. Methods:This cross-sectional study recruited Korean women aged 45-64 years who were perimenopausal and postmenopausal from 16 branch offices of the Korean Association of Health Promotion. All subjects completed self-report questionnaires that asked about a history of premenstrual syndromes, vasomotor symptoms, and several other variables. Results:A total of 1054 participants(361 perimenopausal women and 693 postmenopausal women) completed the study. Severity of premenstrual symptoms significantly correlated with postmenopausal vasomotor symptoms, only in late perimenopausal(r=0.213, p=0.010) and early postmenopausal women(r=0.246, p<0.001). After adjusting for several factors related to vasomotor symptoms, a history of premenstrual syndrome was a significant predictor of moderate to very severe vasomotor symptoms in late perimenopausal(OR=5.197, p=0.005) and early postmenopausal women(OR=3.017, p=0.010). Conclusions:This study suggests that a history of premenstrual syndrome/premenstrual dysphoric disorder is differentially associated with vasomotor symptoms in the menopausal stage. Prospective studies with larger population are needed to confirm these findings

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.47-56
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• 2015

Objectives:The aim of this study is to investigate any differences between non-medical and medical college students for : 1) a level and the nature of perceived stress, 2) a level of life satisfaction, and 3) the related factors affecting to life satisfaction. Methods:We measured self-reported questionnaires of stress, satisfaction with life, health behavior including happiness, alcohol use, nicotine dependency and depressive symptoms in 1,714(863 non-medical and 851 medical) college students. Results:Non-medical college students had significantly higher total stress scores than medical college students(${\chi}^2$=7.66, p<.001). In non-medical college students, employment problem score was significantly higher than medical college students(t=4.07, p<.001). In medical college students, the scores of academic achievement (t=-3.81, p<.001), change of social life(t=-2.03, p<.05), death(t=-2.05, p<.05) or sickness(t=-2.60, p<.05) of friends were significantly higher than non-medical college students. And non-medical college students showed significantly lower life satisfaction scores than medical college students(${\chi}^2$=-19.05, p<.001). We also found that life satisfaction were significantly related to happiness in non-medical college students(${\beta}$=.410, $R^2$=.325, p<.001) and depressive symptoms in medical college students(${\beta}$=-.435, $R^2$=.326, p<.001) by stepwise multiple regression analysis. Conclusions:In this study, a level and the nature of perceived stress, a level of life satisfaction, and the related factors affecting to life satisfaction showed definitely differences between non-medical and medical college students. We suggest with our findings that specified mental health promotion program need for the college student's mental health management.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.36-46
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• 2015

Objectives: To understand the risk factors of demographic data in geriatric depression scale, and suicidality among in elderly who live alone at one urban region. Methods:In 2009, 589 elderly who live alone(age${\geq}$65) were carried out a survey about several socio-demographic data, Korean version of the Geriatric Depression Scale(SGDS-K) and Suicidal Ideation Questionnaire (SIQ). Statistical analysis was performed for the collected data. Results: Mean age of elderly who live alone is 75.69(SD 6.17). 40.1% of participants uneducated, 31.4% graduate from elementary school, 12.9% graduate from high school, 11.7% graduate from middle school, 3.2% graduate from university. Religionless, having past history of depression or physical diseases, low subjective satisfaction of family situation, and not having any social group activity have significance to depressive symptoms of elderly who live alone. Having past history of depression, religionless, low subjective satisfaction of family situation have significance to suicidality. Especially, low subjective satisfaction of family situation and having past history of depression are powerful demographic factor both depressive symptoms and suicidality of elderly who live alone. Conclusions: When we take care elderly who live alone, we should consider many things, but especially the social support network such as family satisfaction and past history of depression for reducing or preventing their depression and suicide both elderly depression and suicide who live alone.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.1
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• pp.26-35
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• 2015

Objectives:The purpose of this study was to evaluate reliability and validity of the Korean version of the Postconcussional Syndrome Questionnaire(KPCSQ) which was originally developed in 1992 by Lees-Haley. Methods:Patients with traumatic brain injury were recruited from April 2009 to December 2011 from the Korean University Ansan Hospital. We selected patients that met the ICD-10 diagnostic criteria of postconcussional syndrome and organic mental disorder including organic mood disorder, organic emotionally labile disorder, organic anxiety disorder and organic personality disorder. The KPCSQ, Trait and State Anxiety Inventory(STAI-I, II), and Center for Epidemiologic Studies Depression Scale(CESD) were administered to all subjects. Factor analysis of the items were performed and test-retest correlation were evaluated. Internal consistency of the KPCSQ and its subscales was assessed with Cronbach's alpha. External validity of the KPCSQ were examined by correlation coefficient with the STAI-I, II, and CESD. Results:The Cronbach's alpha coefficient of the total PCSQ was 0.956. The test-retest reliability coefficient was 0.845. The PCSQ showed significant correlation with STAI-I, II and CESD. The factor analysis of the PCSQ yielded 4 factors model. Factor 1 represented 'affective and cognitive symptoms', factor 2 represented 'somatic symptoms', factor 3 represented 'infrequent symptoms' and factor 4 represented 'exaggeration or inattentive response'. There was no significant difference between the PCS group and the organic mental disorder group in the score on each measure. The scores on KPCSQ and its subscales in the subjects that had scored 5 or more in 'exaggeration or inattentive response' are significantly higher than those in the subjects had scored 4 in 'exaggeration or inattentive response'. Conclusions:This study suggests that the Korean version of PCSQ is a valid and reliable tool for assessing psychiatric symptomatology of patients with traumatic brain injury. Further investigations with greater numbers of subjects are necessary to assess the clinical usefulness of the KPCSQ.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.2
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• pp.93-99
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• 2015

Objectives : The purpose of this preliminary study was to investigate job stress and stress coping strategy among workers in a regional statistics office. Methods : A total of 133 workers in regional statistics office participated in this study and they were divided into two groups, survey group(n=109) and support group(n=24) depending on relation to statistical survey task. They were asked to respond to Short Form of Korean Occupational Stress Scale(KOSS-SF) and Stress Coping Strategy(SCS) to investigate sociodemographic characteristics, job stress, and stress coping strategy. Results : The proportion of the 133 participants in the sample was 59(44.4%) of men, 74(55.6%) of women. There were no significant differences in KOSS-SF scores in relation to age, sex, education, and marital status, while the KOSS-SF scores were significantly different between the two groups. In regard to the subscales of KOSS-SF, the two groups had significant differences in insufficient job control, interpersonal conflict, job insecurity, and organization system. In addition, the total score of KOSS-SF had a negative correlation with problem-focused coping strategy and social support coping strategy of SCS. Conclusions : Our results suggest that workers of survey group had more job stress compared to those who works in support group in regional statistical office. In addition, in comparison with workers of support group, both men and women of survey group get stressed when they were confronted with interpersonal conflicts. Our results suggest that using problem-focused coping and social support coping strategy lowers job stress.