• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.58-66
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• 2021

Objectives : The purpose of this study is to compare the psychosocial characteristics of patients diagnosed with functional gastrointestinal disorder (FGID) by classifying them into irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation (FC), functional heartburn (FH) groups, and overlap group (two or more functional diseases) and to examine the factors associated with the quality of life (QoL) of patients with FGID. Methods : A total of 144 patients who were diagnosed with FGID were selected as the subjects. The demographical factors were investigated; Korean-Beck Depression Inventory-II (K-BDI-II), Korean-Beck Anxiety Inventory (K-BAI), Korean version of Childhood Trauma Questionnaire (K-CTQ), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean Version of Connor-Davidson Resilience Scale (K-CD-RISC), and World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were used to evaluate the psychosocial factors. Results : TThe overlap group had a significantly higher K-BDI-II score (F=11.09, p<0.001) and K-BAI score (F=8.93, p<0.001) compared to other groups. In childhood trauma, the IBS patients had a difference in emotional neglect (F=2.54, p=0.04) than the FD patients. The QoL of FGID patients had a negative correlation with depression (r=-0.196, p<0.01), anxiety (r=-0.235, p<0.01), and childhood trauma (r=-0.222, p<0.01), and a positive correlation with social support (r=0.512, p<0.01) and resilience (r=0.581, p<0.01). Conclusions : Overlap group had a higher level of depression and anxiety, and the IBS patient group had a higher level of emotional neglect than the FD patient group in terms of childhood trauma.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.34-41
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• 2021

Objectives : The purpose of this study is to investigate the characteristics of depressive patients who admitted to general hospital. We examined the clinical characteristics of patients who were referred to the Department of Psychiatry as depressive symptoms, according to the type of consultation request, and comparing 'with re-consultation' and 'without re-consultation' groups. Methods : We performed a retrospective chart review of 4,966 inpatients who were referred to the Department of Psychiatry from August 2005 to December 2011. Results : For about 6 years, among the inpatients referred for psychiatric consultation, a total of 647 patients were referred for depressive symptoms, accounting for 13.82% of the total consultations. The average age of depressive patients was 58.6 years, which was higher than the average of 56.4 years of overall patients. Among the depressive patients, 275 patients were included in 'with re-consultation' group and there was no statistically significant difference when comparing 'with re-consultation' group and 'without re-consultation' group. However, there was a difference in the tendency of the two groups in the type of consultation request. 'With re-consultation' group was in the order of frequency of consultation type 3-2-1, whereas the 'without re-consultation' group was in the order of frequency of consultation type 2-3-1. Conclusions : The group of inpatients who were referred for depressive symptoms in general hospital showed the largest proportion of the group of patients referred to the Department of Psychiatry. 'With re-consultation' group had a higher rate of re-consultation due to the occurrence of new symptoms after hospitalization compared to 'without re-consultation' group. Therefore, doctors in each department and psychiatrists should pay attention to the depressive symptoms of inpatients and actively discuss treatment plans to improve the quality of medical services, identify risk factors, and make efforts to intervene early if necessary.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.17-25
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• 2021

Objectives : This study aimed to investigate quality of life, severity of depression, suicidality, subjective health and subjective stress of depression with subjective cognitive decline in Korean adults. Methods : We used the 7th KNHANES data to enroll 415 participants with a score of 10 or higher on Patient Health Questionnaire-9 (PHQ-9), aged 20-64. Depression was divided into two groups based on the presence/absence of subjective cognitive decline. Demographic and psychological characteristics were compared between two groups. Correlation analysis of subjective cognitive decline, quality of life, depression, suicidal idea was carried out. To detect which variables influenced quality of life, a multiple regression analysis was carried out. Results : Among the 415 participants, 98 had depression with subjective cognitive decline. We identified significant differences in age, marital status, education, employment between the two groups. After adjusting for these variables, depression with subjective cognitive decline had lower EuroQol-5D index scores, more severe depressive symptoms without cognition and worse subjective health than depression without cognitive decline. There was a significant correlation between subjective cognitive decline and quality of life (r=-0.236, p<0.001), suicidal idea (r=0.182, p<0.001), depression score without cognition (r=0.108, p=0.028). Through multiple regression analysis, subjective cognitive decline was predictor of reduced quality of life (β=-0.178, p<0.001). Conclusions : Depression with subjective cognitive decline has poor quality of life and severe depression. Cognitive decline should be considered to improve treatment result in depression.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.67-76
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• 2021

Objectives : The aim of this study was to compare activities of daily living (ADLs) according to degenerative changes in brain [i.e., medial temporal lobe atrophy (MTA), white matter hyperintensities] and to examine the association between neurocognitive functions and ADLs in Korean patients with dementia due to Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods : Participants were 111 elderly subjects diagnosed with AD or MCI in this cross-sectional study. MTA in brain MRI was rated with standardized visual rating scales (Scheltens scale) and the subjects were divided into two groups according to Scheltens scale. ADLs was evaluated with the Korean version of Blessed Dementia Scale-Activity of daily living (BDS-ADL). Neurocognitive function was evaluated with the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet (CERAD-K). Independent t-test was performed to compare ADLs with the degree of MTA. Pearson correlation and hierarchical multiple regression analyses were performed to analyze the relationship between ADLs and neurocognitive functions. Results : The group with high severity of the MTA showed significantly higher BDS-ADL scores (p<0.05). The BDS-ADL score showed the strongest correlation with the word list recognition test among sub-items of the CERAD-K test (r=-0.568). Findings from the hierarchical multiple regression analysis revealed that the scores of MMSE-K and word list recognition test were factors that predict ADLs (F=44.611, p<0.001). Conclusions : ADLs of AD and MCI patients had significant association with MTA. Our study, which identifies factors correlated with ADLs can provide useful information in clinical settings. Further evaluation is needed to confirm the association between certain brain structures and ADLs.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.49-57
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• 2021

Objectives : This study evaluated the medical communication skills of trainee doctors and analyzed the relationship between medical communication skills, self-efficacy on clinical performance (SECP) and empathy. Methods : A total of 106 trainee doctors from a university hospital participated. The questionnaire comprised self-evaluated medical communication skills, modified SECP and the Korean version of the Jefferson Scale of Empathy-Health Professionals version. The mean difference in medical communication skills scores according to gender, age, division (intern, internal medicine group or surgery group) and position (intern, first-/second- and third-/fourth-year residents) were analyzed. Pearson correlation coefficients were determined between medical communication skills, modified SECP and empathy. The effects of each variable on medical communication skills were verified using the structural equation model. Results : There were no statistically significant mean differences in self-evaluated medical communication skills according to gender, age, division or position. Medical communication skills had a significant positive correlation with modified SECP (r=0.782, p<0.001) and empathy (r=0.210, p=0.038). Empathy had a direct effect on modified SECP (β=0.30, p<0.01) and modified SECP had a direct effect on medical communication skills (β=0.80, p<0.001). Empathy indirectly influenced medical communication skills, mediating modified SECP (β=0.26, p<0.05). Conclusions : Medical communication skills are an important core curriculum of residency programs, as they have a direct correlation with SECP, which is needed for successful treatment. Moreover, the medical communication needs a new understanding that is out of empathy.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.116-125
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• 2020

Objectives : Self-poisoning is the leading cause of visits to the emergency departments after a suicide attempts. This study is aimed to compare the patient characteristics according to the category of drugs ingested by the patients who attempted suicide. Methods : All medical charts were retrospectively reviewed from patients who visited the emergency center, at Seoul Medical Center, due to intentional self-poisoning from April of 2011 to July of 2019. We investigated the information regarding the subtype and quantity of the intoxication drug, how it was obtained, suicidal history, and psychiatric history, as well as, sociodemographic information. Variables were compared between prescription drug (PD) and non-prescription drug (NPD) poisoning groups. Results : The mean age of the NPD poisoning group was significantly lower than that of the PD poisoning group. The patient ratio of those enrolled in national health insurance and living with spouses were significantly higher in the NPD poisoning group. Compared to the NPD poisoning group, the PD poisoning group had a higher incidence of mental illnesses, underlying diseases and ratio of involuntary visit to the emergency department. Among the prescription drugs, the benzodiazepine poisoning group had a higher rate of self-prescription than the non-poisoning group, while the zolpidem poisoning group had a higher rate of the using someone else's prescription than other drugs. Each single drug poisoning group (benzodiazepine, zolpidem, and antidepressant single-agent) had a higher rate of no mental illness than each of the mixed-poisoning group. Conclusions : Guidelines for regulating non-prescription drugs are needed as a matter of suicide prevention. Also, this study suggests that clinicians need to be careful when issuing prescriptions and should suicidal risk according to patients' characteristics, duration of follow-up and type of drug packaging.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.143-154
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• 2020

Objectives : The purpose of this study was to examine cognitive and psychological characteristics of patients with military service suitability issues compared to the general psychiatric outpatients. Methods : 108 patients who visited psychiatric clinic center due to military service suitability issues and 80 general psychiatric patients were recruited from the Department of Psychiatry of university hospital. ANCOVA and chi-equare test were used to examine differences between two groups. Furthermore, we utilized paired t-test to compare the scrore within military group depending on when they performed the psychological assessment. Results : There were no significant differences between military group and general outpatient group in WAIS-IV scores. However, military group scored remarkably higher than control group on validity scales, F-r and Fp-r whereas they scored lower on validity scale, K-r. Furthermore, military group showed significantly higher on BDI and MMPI-2-RF, EID, RCd, RC2, RC3, COG, HLP, SFD, NFC, STW, SAVE, SHY, DSF, NEGE-r, INTR-r. As a result of comparison within the military group following the periods of assessment, military group did not show the significant differences on the overall scales of MMPI-2-RF. Conclusions : The present study showed that military group tends to report their psychological distress more exaggeratedly. In addition, they had significantly elevated not only emotional distress such as depression and anxiety but interpersonal problem. The implications and limitations were discussed along with some suggestions for the future studies.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.1
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• pp.16-21
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• 2022

Objectives : The purpose of this study is to investigate depression and suicide ideation according to socioeconomic changes after COVID-19 among Korean adolescent. Methods : Data on the study population were obtained from the 16th Korea Youth Risk Behavior Web-based Survey (KYRBS). The KYRBS is a nationally representative sample of Korean adolescents (aged 12-18 years) that originally included over 103 questions in 15 domains of health-risk behaviors. In the 16th KYRBS, a total 54,948 students from 793 schools responded to the survey. Chi-square test and logistic regression analysis were conducted regarding depression and suicide ideation. Results : This study suggests that changes in the family household before and after COVID-19 pandemic are also affecting the mental health of the adolescents. The study shows that worse change of family household is significant associations with suicidal ideation and depression. Adolescents reporting worse (AOR 1.38; 95% CI 1.38-1.57) and much worse (AOR 2.07; 95% CI 1.87-2.29) were significantly more likely to report depression. Adolescents reporting worse (AOR 1.34; 95% CI 1.34-1.60) and much worse (AOR 2.01; 95% CI 1.76-2.29) were significantly more likely to report suicide ideation. Conclusions : In this study, it was confirmed that young people from socially disadvantaged backgrounds are at high risk of suicide ideation and more depression. The results of this study suggest that we should consider improving the screening and prevention of mental health problems for adolescents with poor socioeconomic changes of COVID-19.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.153-161
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• 2021

Objectives : The purpose of this study is to compare bleeding tendency of selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI) using platelet function analyzer (PFA-100) in patients with major depressive disorder. Methods : This study is a prospective open-label study conducted by a single institution. A total of 41 subjects diagnosed with major depressive disorder under the DSM-5 diagnostic criteria participated in this study. The subjects were classified into SSRI (escitalopram) groups and SNRI (duloxetine) groups, respectively, according to random assignments. The closure time (CT) was measured using a platelet function analyzer (PFA-100) before each antidepressant was administered and after 6 weeks. Paired-sample t-test was conducted within each group to determine whether a specific antidepressant had an effect on closure time. In order to confirm the relative change in platelet function between the two groups, an independent sample t-test was conducted to compare and analyze the change in closure time between the two groups. Results : There was no significant changes in closure time (CEPI-CT, CADP-CT) before and 6 weeks after drug administration in the SSRI and SNRI groups, and there was no difference in the amount of changes in closure time between the two groups. Conclusions : Our results showed no difference in bleeding tendency between SSRI and SNRI. This study suggests that further large-scale studies on bleeding tendency for various antidepressants are needed in the future.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.111-120
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• 2021

Objectives : Shift work has been known to cause various health problems by making it difficult for humans to adapt to their natural circadian rhythms. In particular, shift workers tend to complain of sleep difficulties associated with work schedules, and sometimes use alcohol as a self-medication to induce sleep. To date, no clear mechanism has been identified regarding the link between shift work and sleep, between shift work and drinking. This study aims to confirm the relationship between shift work and sleep, and to analyze whether the change in sleep caused by shift work causes drinking. Methods : This study included 11360 people (5704 men and 5656 women) among the Korean National Health and Nutrition Survey data in 2014, 2016 and 2018. The work type between 6am-6pm was defined as day work, and other work types were defined as shift work. Using logistic regression analysis, the relationship between shift work and sleep quality, shift work and high risk drinking, drinking amount at 1 time, drinking frequency were analyzed. In addition, we analyzed whether sleep mediates the relationship between shift work and drinking using mediated analysis. Results : Shift work showed a significant negative relationship with sleep quality in men and women (male OR=1.37, 95% CI 1.11-1.70, female OR=1.26, 95% CI=1.05-1.50). There was no significant relationship between shift work and alcohol in the case of men, but in the case of women, there was a significant positive relationship between shift work and the number of alcohol consumption (OR=1.34, 95% CI=1.04-1.72). When mediation analysis was conducted, it was found that women's sleep quality partially mediated the relationship between shift work and the frequency of drinking. Conclusions : The results of this study suggest that shift work causes sleep difficulties, and in the case of women, drinking can be induced through the partial mediating effect of sleep. Considering that women are more likely to choose drinking as a coping method for sleep problems, more active interventions for female shift workers are needed.