• Journal of Trauma and Injury
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• v.36 no.4
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• pp.376-384
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• 2023

Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

• Anxiety and mood
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• v.15 no.1
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• pp.45-52
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• 2019

Objective : The objective of this study is to determine the effects of fear of Middle East respiratory syndrome (MERS) on socio-psychological health during an outbreak of MERS and the post-traumatic stress as a mediator on the relationship between stress and socio-psychological health. Methods : Visual Analog Scale, Impact of Event Scale -Revised, Psychosocial well-being index short form was implemented for 150 medical persons who worked at the hospital in which exposure to MERS cases had been confirmed and 96 ordinary people. A Pearson correlation coefficient and a hierarchical multiple regression was carried out to confirm the effect of fear of MERS and the mediating effect of post-traumatic stress between fear and socio-psychological health. Results : The higher the fear, the lower the socio-psychological health in both healthcare workers and the public (r=0.32, p<0.01) and the higher post-traumatic stress (r=0.32, p<0.01). But, the research results showed that only healthcare workers had a partially mediating effect of post-traumatic stress in the relationship between fear and socio-psychological health (${\beta}=0.45$, t=6.33 p<0.001), (${\beta}$ value : 0.39>0.26). Conclusion : This study demonstrated that the post-traumatic stress can indirectly lead to a negative effect on the socio-psychological health of healthcare workers when under the fear of MERS and shows adverse effects on psycho-social wellbeing. This suggests that clinical intervention and psycho-social approach aiming at reducing post-traumatic stress is important to maintain mental health during crisis development.

• Journal of Digital Convergence
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• v.16 no.3
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• pp.561-572
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• 2018

The purpose of this study is to examine the effect of Acceptance and Commitment Therapy(ACT) on Complex PTSD symptoms, acceptance and post-traumatic growth of college students with childhood emotional abuse. Four hundred and fifty students in university completed Acceptance and action Questionnaire(AAQ-II), Structured interview for disorders of extrem stress(SIDES), Korea version posttraumatic growth inventory(K-PTGI). 14 participants was selected from that result. 7 participants were assigned to the ACT group and the others were in the control group. ACT program was administered for 8 sessions twice a week for 2 month, approximately 100 minutes. There was no treatment in the control group. All participants completed post-test at the end of treatment and then follow-up test after 6 weeks. The results were that complex PTSD symptoms level in ACT group was significant decreased and acceptance and post-traumatic growth level in ACT group were significant increased than those in control group at the end of treatment and the follow-up period. Finally, the implications and the limitations of this study, and the suggestions for future study were also discussed.

• Anxiety and mood
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• v.7 no.2
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• pp.107-112
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• 2011

Objective : This study aimed to ascertain the effect of interpersonal sensitivity/resilience on depression and anxiety in firefighters whose frequency of exposure to traumatic events is high. Method : A survey was performed and data related to 75 firefighters were analyzed. Questionnaires included the Beck Depression Inventory (BDI) and Impact of Event Scale-Revised (IES-R). To assess the susceptibility or protector roles with respect to psychopathology, the Interpersonal Sensitivity Measure (IPSM) and Conner-Davidson Resilience Scale (CD-RISC) were used. Results : The personality characteristic, interpersonal sensitivity (IPSM) showed a significant positive correlation with depression (BDI, r=0.557, p<0.001) and posttraumatic stress symptoms (IES-R, r=0.316 ; p<0.001). In contrast, resilience and symptom parameters (BDI, IES-R) were negatively correlated with each other, but not statistically significant. However, an adaptive factor for change, a third sub-factor of CD-RISC, had significant negative correlation with depression and anxiety symptoms (BDI, r=-0.275, p<0.005 ; IES-R, r=-0.254, p<0.005). Conclusion : The results of the present study showed that some personality traits may act as vulnerability or protective factors with respect to the psychopathologies of depression and anxiety.

• Anxiety and mood
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• v.5 no.1
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• pp.29-35
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• 2009

Background : In spite of the worldwide relevance of obsessive-compulsive disorder Ed-highlight : Unclear. Perhaps consider changing word choice. (OCD), there are considerable differences in prevalence, sex ratio, comorbidity patterns, and sociodemographic correlates. Data on subclinical OCD have been sparse to date. Methods : Data stemmed from the Korea Epidemiologic Catchment Area (KECA) study which had been carried out from April to December 2001. Korean versions of DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 6275 persons aged 18-64 living in the community. DSM-IV based criteria for subclinical OCD were applied. Results : The lifetime prevalence rates for OCD and subclinical OCD were 0.8% and 6.6%, respectively. In both OCD and subclinical OCD, the rates for males and females were not statistically different. OCD was demonstrated to be associated with depressive disorder, bipolar disorder, social phobia, generalized anxiety disorder, and alcohol and nicotine dependence. Additionally, subclinical OCD was associated with posttraumatic stress and somatoform disorders. Comorbidity rates in subclinical OCD were lower than those in OCD. Conclusions : The lifetime prevalence rate for OCD was less than 1% in the Korean general population. Age distribution and comorbidity patterns suggest that subclinical OCD represents a broad and heterogeneous syndrome and not simply a milder form of OCD.

• Korean Journal of Biological Psychiatry
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• v.17 no.2
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• pp.94-102
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• 2010

Objectives : Eye movement desensitization and reprocessing(EMDR) is a novel, time-limited psychotherapy originally developed for treatment of psychological trauma. The effectiveness of this therapy has been validated only for posttraumatic stress disorder ; however, EMDR is often applied to other psychiatric illnesses, including other anxiety disorders and depression. This pilot study tested the efficacy of EMDR added to the routine treatment for individuals with acute stage schizophrenia. Methods : This study was conducted in the acute psychiatric care unit of a university-affiliated training hospital. Inpatients diagnosed with schizophrenia were randomly assigned to either three sessions of EMDR, three sessions of progressive muscle relaxation(PMR) therapy, or only treatment as usual(TAU). All the participants received concurrent typical treatments(TAU), including psychotropic medication, individual supportive psychotherapy and group activities in the psychiatric ward. The Positive and Negative Syndrome Scale(PANSS), the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale were administered by a clinical psychologist who was blinded to the patients' group assignment. Results : Forty-five patients enrolled and forty patients(89%) completed the post-treatment evaluation. There were no between-group differences in the withdrawal rates of patients during the treatment or at the three-month follow-up session. All three groups improved significantly across each of the symptomatic domains including schizophrenia, anxiety, and depressive symptoms. However, a repeated measures ANOVA revealed no significant differences among the groups over time. Effect size for change in total PANSS scores was also similar across treatment conditions, but effect size for negative symptoms was large for EMDR(0.60 for EMDR, 0.39 for PMR and 0.21 for TAU only). Conclusion : These findings supported the use of EMDR in treating the acute stage of schizophrenia but the results failed to confirm the effectiveness of the treatment over the two control conditions in three sessions. Further studies with longer courses of treatment, more focused target dimensions of treatment, and a sample of outpatients are necessary.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.35-43
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• 2018

Objectives : Effects of multiple trauma are complex and extend beyond core PTSD symptoms. However, few psychological instruments for trauma assessment address this issue of symptom complexity. The Trauma Symptom Checklist-40 (TSC-40) is a self-report scale that assesses wide range of symptoms associated with childhood or adult traumatic experience. The purpose of the present study was to evaluate the validity of the Korean Version of the TSC-40 in a sample of psychiatric outpatients. Methods : Data of 367 treatment-seeking patients with DSM-IV diagnoses were obtained from an outpatient department of psychiatric unit at a university hospital. The diagnoses were anxiety disorder, posttraumatic stress disorder, depressive disorder, adjustment disorder and others. Included in the psychometric data were the TSC-40, the Life events checklist, the Impact of Event Scale-Revised, the Zung's Self-report Depression Scale, and the Zung's Self-report Anxiety Scale. Cronbach's ${\alpha}$ for internal consistency were calculated. Convergent and concurrent validity was approached with correlation between the TSC-40 and other scales (PTSD, anxiety and depression). Results : Exploratory factor analysis of the Korean Version of TSC-40 extracted seven-factor structure accounted for 59.55% of total variance that was contextually similar to a six-factor structure and five-factor structure of the original English version. The Korean Version of TSC-40 demonstrated a high level of internal consistency. (Cronbach's ${\alpha}=0.94$) and good concurrent and convergent validity with another PTSD scale and anxiety and depression scales. Conclusions : Excellent construct validity of The Korean Version of TSC-40 was proved in this study. And subtle difference in the factor structure may reflect the cultural issues and the sample characteristics such as heterogeneous clinical population (including non-trauma related disorders) and outpatient status. Overall, this study demonstrated that the Korean version of TSC-40 is psychometrically sound and can be used for Korean clinical population.