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Background: Patients with subthreshold bipolar disorder (Sub-BP) experience severe clinical courses and functional impairments which are comparable to those with bipolar I and II disorders (BP-I and -II). Nevertheless, lifetime prevalence, socioeconomic correlates and diagnostic overlaps of bipolar spectrum disorder (BPS) have not yet been estimated in the general population of South Korean adults., Methods: A total of 3013 adults among the 2011 Korean Epidemiologic Catchment Area survey (KECA-2011) completed face-to-face interviews using the Korean versions of the Composite International Diagnostic Interview 2.1 and Mood Disorder Questionnaire (K-CIDI and K-MDQ)., Results: The lifetime prevalence of BPS in the South Korean adults was measured to be 4.3% (95% CI 2.6-6.9). Nearly 80% of the subjects with BPS were co-diagnosed with other DSM-IV non-psychotic mental disorders: 35.4% (95% CI 24.2-48.5) for major depression and dysthymic disorder, 35.1% (95% CI 27.7-43.3) for anxiety disorders, and 51.9% (95% CI 40.5-63.1) for alcohol and nicotine use disorders. Younger age (18-34 years) was the only sociodemographic predictor of BPS positivity (P=0.014), and the diagnostic overlap patterns were different between men and women., Limitations: The prevalence of BPS and other mental disorders could have been influenced by recall bias due to the retrospective nature of this study., Conclusions: Positivity for BPS was estimated to be much greater than the prevalence of DSM-IV BP in South Korea. Most of the respondents with BPS were diagnosed with other major mental disorders and this might be related with mis- and/or under-diagnosis of clinically relevant Sub-BP., (Copyright © 2016 Elsevier B.V. All rights reserved.)

This study assessed the association between experiencing physical or sexual intimate partner violence (IPV) and mental health among women in the general Korean population. A total of 3160 South Korean women aged 18 to 74 responded to the Korean version of the WHO-Composite International Diagnostic Interview (K-CIDI), version 2.1., and questions about IPV. Multiple logistic regression was used to examine the odds of developing mental disorders associated with each type of IPV. Victimization by any type of IPV was associated with significantly increased odds of experiencing any mental disorders in the lifetime (OR 4.4, 95% CI 2.4–8.0). Participants who experienced sexual IPV had the highest odds of having mental disorders (OR 14.3, 95% CI 4.1–54.8). Sexual IPV experience among participants was associated with higher odds of major depressive disorder, anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, specific phobias, agoraphobia, and nicotine dependence. Alcohol use disorder was highly associated with experiencing physical IPV (OR 3.8, 95% CI 1.7–8.0). Among women who experienced IPV, the youngest age group, from 18 to 35 years old (2.6%, 95% CI 1.4–3.8), and the never married group (2.7%, 95% CI 1.2–4.2) experienced the highest proportion of any form of IPV. Mental disorders throughout the lifetime are highly associated with the experience of IPV among women and are most prevalent among those who experienced sexual IPV. Thus, to prevent mental disorders among female IPV victims, treatment specific to each type of IPV should be provided early. [ABSTRACT FROM AUTHOR]

Individuals with posttraumatic stress disorder (PTSD) are more prone to suicidal ideation and behavior. While those who have experienced interpersonal trauma exhibit more suicidality than those who have experienced non-interpersonal trauma, it is unclear how the traumatic effects are related to an individual’s personality characteristics. This study examined the association between interpersonal trauma and personality factors with suicidality, and elucidated the moderating role of interpersonal trauma in individuals with PTSD. The study included 6,022 participants from the Korean Epidemiologic Catchment Area Study 2011. The Korean Version of Composite International Diagnostic Interview was used for the survey, including the participants’ history of suicidality, the traumas they have experienced, and their PTSD symptoms. The 11-item version of the Big Five Inventory (BFI-11) was used to assess the participants’ personality factors. 76 individuals were diagnosed with PTSD, while 810 had been exposed to trauma but were not diagnosed with any DSM-IV mental disorder. Among the individuals with PTSD, those who had experienced interpersonal trauma were more likely to have suicidal ideation than those who had experienced non-interpersonal trauma (p = .020; odds ratio [OR] = 3.643; 95% confidence interval of OR = [1.226, 10.825]). High agreeableness and conscientiousness predicted less suicidality in those exposed to non-interpersonal trauma, while predicting more suicidality in those exposed to interpersonal trauma. Clinicians examining individuals with PTSD should pay closer attention to the trauma that they have experienced, as well as their personality factors, to provide appropriate treatment. [ABSTRACT FROM AUTHOR]

Background: Subthreshold depression and anxiety are highly prevalent and known to be associated with functional limitations and future onset of major depression or anxiety disorders. However, studies regarding suicidality at subthreshold levels of depression and anxiety are limited.Methods: A total of 17,639 Koreans aged from 18 to 64 responded to the Korean version of the WHO-composite international diagnostic interview (K-CIDI) version 2.1 between 2006 and 2016. Prevalence of subthreshold depression and anxiety, and information on lifetime suicide attempt (SA) were assessed. Multivariable logistic regression was performed to calculate the risk of SA by the level of depression or anxiety.Results: The risk of lifetime SA increased incrementally according to the level of depression and anxiety. In the subthreshold depression group, individuals with subthreshold anxiety increased the odds about threefold (OR = 3.15, 95% CI 3.12-3.18) and the threshold anxiety disorder group increased the odds about fivefold (OR = 5.33, 95% CI 5.27-5.38) for SA, compared to the group without any level of anxiety. In threshold depressive disorder, the subthreshold anxiety group showed about 1.8-fold higher odds (OR = 1.76, 95% CI 1.75-1.77) and the threshold anxiety disorder group showed threefold higher odds (OR = 2.93, 95% CI 2.92-2.95) for SA compared to the group without any level of anxiety.Conclusions: Subthreshold levels of depression and anxiety were prevalent among Koreans and were associated with an increased prevalence of lifetime SA. A detailed assessment of depression and anxiety symptoms according to their level should be performed on a diagnostic continuum to prevent suicide. [ABSTRACT FROM AUTHOR]

Backgrounds: Panic disorder is a highly prevalent psychiatric disorder that substantially impairs quality of life and psychosocial function. Panic disorder arises from neurobiological substrates and developmental factors that distinguish it from other anxiety disorders. Differential diagnosis between panic disorder and other anxiety disorders has only been conducted in terms of a phenomenological spectrum.Methods: Through a machine learning-based approach with heart rate variability (HRV) as input, we aimed to build algorithms that can differentiate panic disorder from other anxiety disorders. Five algorithms were used: random forest (RF), gradient boosting machine (GBM), support vector machine (SVM), artificial neural network (ANN), and regularized logistic regression (LR). 10-fold cross-validation with five repeats was used to build the final models.Results: A total of 60 patients with panic disorder and 61 patients with other anxiety disorders (aged between 20 and 65 years) were recruited. The L1-regularized LR showed the best accuracy (0.784), followed by ANN (0.730), SVM (0.730), GBM (0.676), and finally RF (0.649). LR also had good performance in other measures, such as F1-score (0.790), specificity (0.737), sensitivity (0.833), and Matthews correlation coefficient (0.572).Limitations: Cross-sectional design and limited sample size is limitations.Conclusion: This study demonstrated that HRV can be used to differentiate panic disorder from other anxiety disorders. Future studies with larger sample sizes and longitudinal design are required to replicate the diagnostic utility of HRV in a machine learning approach. [ABSTRACT FROM AUTHOR]

Despite the high prevalence of alcohol use disorders (AUDs) in Korea, few studies have been conducted on the temporal priority with comorbid mental disorders. We investigated the temporal priority of lifetime AUDs and comorbid mood and anxiety disorders among the general population of Korea. Data of 18,807 respondents aged 18 years or older, collected from three national epidemiological surveys comprising face-to-face interviews using the Korean version of the Composite International Diagnostic Interview for DSM-IV mental disorders. For each mood or anxiety disorder, the extent to which one mental disorder precedes another was investigated by calculating the proportion of primary AUDs by that of primary mood or anxiety disorder. Regarding alcohol dependence, dysthymic disorder is 5.6 times more likely to occur before alcohol dependence. Moreover, generalized anxiety disorder, social phobia, and specific phobia are 3.6 times, 4.5 times, and 6.3 times more likely to occur before, respectively. Regarding alcohol abuse, specific phobia is 6.3 times more likely to occur before, whereas major depressive disorder is two times more likely to occur after. Moreover, the lag times between primary alcohol abuse and subsequent mood or anxiety disorders were longer than those between primary alcohol dependence and the latter. The age of onset might be subject to recall bias. The presence of non-respondents could have influenced the results. We need to recognize that one of the mental disorders could lead to another and consider it in the management of people with AUDs or mood and anxiety disorders. • We studied the temporal priority of AUDs and comorbid mood and anxiety disorders. • Phobias are more likely to occur before than after AUDs. • MDD is more likely to occur after than before alcohol abuse. • Notably, each disorder represents a risk of the subsequent disorder. [ABSTRACT FROM AUTHOR]