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While previous studies have suggested that snoring may be associated with depressive symptoms and suicidality in adults and preschool children, there have been no investigations in non-clinical adolescent populations. This study aimed to demonstrate the association between snoring and depressive symptoms/suicidality in adolescents. This survey study recruited 8530 students (grades 7-11) and examined depressive symptoms, suicidality, snoring frequency, daytime sleepiness, sleep duration, and presence of insomnia by questionnaires. Correlation analyses, multiple linear regression analyses and mediation analyses were performed to determine the association between snoring frequency and depressive symptoms/suicidality. The study population included 8080 students (16.73 ± 1.09 years old). Snoring frequency was positively correlated with depressive symptoms and suicidality. Snoring frequency was associated with depressive symptoms and suicidality when adjusted for age and sex, and the association remained significant after additionally adjusting for sleep duration, insomnia, and daytime sleepiness. When depressive symptoms were included as a predictor of suicidality, snoring frequency showed no significant predictive value. Mediation analysis confirmed that depressive symptoms mediate the association between snoring frequency and suicidality. Our findings suggest that self-reported complaints of snoring are associated with increased depressive symptoms and suicidality in adolescents independently of sleep duration, insomnia, and daytime sleepiness, and the connection between snoring and suicidality is mediated by depressive symptoms. These data underscore the importance of identifying snorers among adolescents and screening for depression and suicidal ideation in this population., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Evidence continues to accumulate that the presence or absence of early trauma (ET) implies unique characteristics in the relationships between suicidal ideation and its risk factors. We examined the relationships among recent stress, depressive symptoms, anxiety symptoms, and suicidal ideation in Korean suicidal women with or without such a history., Methods: Using data on suicidal adult females, 217 victims and 134 non-victims of ET, from the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior, we performed structural equation modeling to investigate the contribution of recent stress, depressive symptoms, and anxiety symptoms on suicidal ideation within each group according to the presence or absence of a history of ET., Results: Structural equation modeling with anxiety and depressive symptoms as potential mediators showed a good fit. Recent stress had a direct effect on both depressive symptoms and anxiety symptoms in both groups. Only anxiety symptoms for victims of ET (standardized regression weight, 0.281; P = 0.005) and depressive symptoms for non-victims of ET (standardized regression weight, 0.326; P = 0.003) were full mediators that increased suicidal ideation. Thus, stress contributed to suicidal ideation by increasing the level of anxiety and depressive symptoms for victims and non-victims, respectively., Conclusion: Tailored strategies to reduce suicidal ideation should be implemented according to group type, victims or non-victims of ET. Beyond educating suicidal women in stress-management techniques, it would be effective to decrease anxiety symptoms for those with a history of ET and decrease depressive symptoms for those without such a history., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2021 The Korean Academy of Medical Sciences.)

Background: Magnesium (Mg 2+ ), an endogenous N-methyl-D-aspartate receptor antagonist, has received increased attention recently because of its role in the pathophysiology of and treatment response in depression. However, whether Mg 2+ level is decreased in depression is not firmly established. We aimed to conduct a systematic review and meta-analysis to help making consensus for the association between Mg 2+ levels and depression., Methods: A systematic search was conducted in the electronic database resources PubMed and Embase. After a careful selection of relevant studies, a meta-analysis using the random effects model was conducted in each measuring source, such as serum, plasma, and cerebrospinal fluid (CSF)., Results: A total of 18 studies were included in this study. Among 11 studies that measured Mg 2+ in the serum, Mg 2+ level was lower in patients with depression than in controls (weighted mean difference  = -.088, 95% confidence interval  = -.164 to -.012). In the sensitivity analysis by removing studies one by one, 2 out of the 11 studies obliterated such significant differences. There were no significant differences in the Mg 2+ levels in the studies for plasma and CSF., Conclusions: Despite some evidence supporting an association between decreased Mg 2+ levels and depression from studies with serum, the results of our meta-analysis urge to use caution when associating Mg 2+ levels and depression. Future studies are needed to establish a consensus for the role of low Mg 2+ levels in depression.

ABSTRACTObjective:Our aim was to examine the prevalence, correlates, and association of depressive and anxiety disorders with quality of life (QoL) and such other outcomes as the need for psychosocial services in cancer patients., Method: A total of 400 patients participated in a multicenter survey involving five cancer centers located throughout Korea. The Short-Form Health Survey, the MD Anderson Symptom Inventory, the Mini-Mental Adjustment to Cancer (MINI-MAC), and Mini-International Neuropsychiatric Interview were administered., Results: The prevalence rates for depressive and anxiety disorders were 16 and 17.1%, respectively. Younger age and poor Eastern Cooperative Oncology Group performance status, and all physical symptoms, as well as helplessness/hopelessness, anxious preoccupation (AP), and cognitive avoidance (CA) on the MINI-MAC were found to be significantly related to depressive disorder (DD) in a univariate logistic regression analysis. Metastases, the symptoms of disturbed sleep, dry mouth, and numbness or tingling, as well as AP and CA were significantly correlated with anxiety disorder (AD) in the univariate analysis. In the multivariate analyses, only AP was significant for AD (odds ratio = 2.94, p < 0.001), while none reached statistical significance for DD. Psychiatric comorbidity status had a detrimental effect on various dimensions of QoL. Patients with DD or AD reported a significantly higher need for professional psychosocial services., Significance of Results: Given the substantial prevalence and pervasive impact of DD and AD on various aspects of QoL, its assessment and care should be integrated as a regular part of oncological care throughout the cancer continuum.

This study investigated gender differences in symptom profiles of major depressive disorder (MDD) in the Korean general population. Data were pooled from the series of nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001, 2006 and 2011, respectively. Of the 18,807 participants, 507 (397 women and 110 men) were diagnosed with MDD within the prior 12 months. In agreement with previous studies, women with MDD appeared to be more vulnerable to experiencing atypical depressive episodes defined as depression with two or more symptoms of fatigue, increased appetite and hypersomnia (P < 0.001). In terms of individual symptoms, female gender was significantly related with higher prevalence of fatigue (P = 0.008), hypersomnia (P = 0.001), noticeable psychomotor retardation (P = 0.029) and suicidal attempts (P = 0.016) with adjustment for birth cohort effect, partner status, and employment status. In the same analysis, men with MDD appeared more vulnerable to decreased libido than women (P = 0.009). This is the first report to demonstrate gender differences in symptomatology of MDD in the general Korean population, and the results are comparable to previous investigations from western societies. Assumingly, the intercultural similarity in female preponderance to atypical depression might reflect the common biological construct underlying the gender difference in mechanism of MDD. In clinical settings, gender differences of MDD should be carefully considered, because these features could be related with treatment response and drug side effects.

Studies have suggested that psychotic-like experiences (PLEs) are associated with behavioral problems in adolescents. The aim of this study was to investigate relationships between domains of PLEs, suicidal ideation, and depression in a large community sample of adolescents. The sample consisted of 8096 Korean subjects (3184 boys and 4912 girls) aged 14 to 19 years. The level of PLEs, depression, and suicidal ideation were assessed by the Eppendorf schizophrenia inventory (ESI), Beck's depression inventory, and Beck's scale for suicidal ideation, respectively. Both the level of depression and suicidal ideation were significantly associated with PLEs. Among the four domains of the ESI, the deviant perception, ideas of reference, and auditory uncertainty were associated with the suicidal ideation. Additionally, subjects with more PLEs had significantly more suicidal ideation and depressive symptoms. PLEs in adolescents are associated with potential risk of suicide and depressive symptoms significantly mediated the association between suicidal ideation and PLEs. The presence of perceptual disturbances, ideas of reference, and depression may be regarded as warning signs for suicide-related behaviors., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

The aim of this study was to examine the patterns of use and perceived helpfulness of self-help interventions for depressive symptoms and sub-threshold depression in Korean samples drawn from the general population, patients with depression, and psychiatrists. A total of 1000 adults from the community, 114 patients with sub-threshold or mild depression, and 201 psychiatrists were asked to complete questionnaires about the use and helpfulness of 20 self-help interventions for depression chosen via the Delphi method. Psychiatrists (82.6%) and the general population (67.2%) were more likely to prefer self-help methods than were patients with depressive disorders (28.4%). Lifestyle change and psychological approaches were the preferred interventions among those with depressive disorders. Although the general population was more likely to prefer to use health supplements and dietary interventions, the perceived helpfulness of these approaches was generally lower than that of the other interventions. Although self-help strategies have been widely used, psychiatrists, patients with depression, and the general population differ with respect to their preferred intervention. Members of the general population were more likely than were psychiatrists and patients to use not consensually accepted interventions. The evidence-based use of self-help strategies for depression should be promoted by providing information about their effectiveness., (Copyright © 2014 John Wiley & Sons, Ltd.)

Objectives: We aimed to investigate the moderating effect of age on the association of morningness-eveningness with depression in subjects with a broad range of ages. The hypothesis of the current study was that there would be a relationship between depressive symptoms and eveningness, especially in young age groups., Methods: Three hundred sixty-one subjects (male/female=140/221) from 19 to 79 years of age participated in the study. Subjects were separated into five age groups: (1) < or = 20s (n=70), (2) 30s (n=85), (3) 40s (n=97), (4) 50s (n=54) and 5) > or = 60s (n=55). The Horne-Osteberg Morningness-Eveningness Questionnaire (MEQ) and the Center for Epidemiological Studies for Depression Scale (CES-D) were administered to all subjects., Results: MEQ showed a significantly independent and negative association with CES-D (beta=-.27, P<.001), which meant the association between eveningness and depressive symptoms. The negative association between MEQ and CES-D were significant in < or = 20s (beta=-.31, P=.01), 50s (beta=-.38, P<.01) and > or = 60s (beta=-.35, P<.01), while there was no significant association between MEQ and CES-D in 30s (beta=-.06, P=.56) and 40s (beta=-.10, P=.32)., Conclusion: Our findings demonstrate an association of depressive symptoms with eveningness, which was more prominent in younger or older aged than in middle aged. Our findings suggest that the association between depressive symptoms and eveningness might be moderated by age., (2010 Elsevier Inc. All rights reserved.)

Background: Early life traumatic events and recent stressful events are known to have especially strong effects on emotional wellbeing. However, little is known about the interaction of early and recent stressors on emotions. We aimed to examine the interactive effects of early trauma and recent stressors on depression, anxiety, and anger. Methods: One hundred and seventy adults were recruited and asked to complete the Center for Epidemiological Studies Depression Scale (CES-D), the state anxiety subscale of the State–Trait Anxiety Inventory (STAI-S), and the state anger subscale of the State–Trait Anger Expression Inventory (STAXI-S). Early traumas and recent stressors were assessed during face-to-face interviews. Multiple regression analysis was performed to test whether early trauma, recent stressors, and the interaction of the two would predict CES-D, STAI-S, and STAXI-S scores. Results: In the multiple regression models, STAI-S scores were predicted only by recent stressors (R2 = 0.063, p = 0.001). In contrast, CES-D and STAXI-S scores were predicted only by the synergistic interaction of early trauma with recent stressors (R2 = 0.075, p < 0.001; R2 = 0.039, p = 0.01, respectively). Conclusions: A synergistic interaction effect between early trauma and recent stressful events on current depression and anger was observed, indicating that the combined effects of early trauma and recent stressors are stronger than their individual effects. In contrast, anxiety was affected mainly by recent stressors. Our findings suggest that the form that emotional disturbance takes can vary depending on the timing of stressors. [ABSTRACT FROM AUTHOR]

Objective: To report the development and validation of the National Cancer Center Psychological Symptom Inventory (NCC-PSI).Methods: Psychometric properties of the NCC-PSI were examined by using multicenter surveys involving 400 patients with cancer in 5 cancer-treatment hospitals throughout Korea. Related measures including the Mini-International Neuropsychiatric Interview were administered.Results: Convergent validity was supported by NCC-PSI's significant associations with related measures. Known-group validity was proven with higher scores of helplessness/hopelessness and anxious preoccupation on the Mini-Mental Adjustment to Cancer in the depression and anxiety diagnosis group, defined by the NCC-PSI. Cutoff scores for insomnia, anxiety, and depression were identified. Overall, the screening performance of the NCC-PSI was comparable to that of the distress thermometer and Patient Health Questionnare-2.Conclusions: The NCC-PSI represents a meaningful effort to develop a distress screening tool that addresses specific psychological symptoms common in cancer, which are tailored to the local oncology care system with varying degrees of psychosocial care resources. [ABSTRACT FROM AUTHOR]

Objective: To assess the cost-effectiveness of vortioxetine versus venlafaxine XR (extended-release) in major depressive disorder (MDD) patients in South Korea.Methods: A 1-year cost-effectiveness analysis from a limited societal perspective was performed using a combined model consisting of a decision-tree and a Markov model. Patients entered the model when initiating or switching antidepressant treatment following inadequate response to previous treatment. Remission, relapse and recovery were the main health states.Results: Vortioxetine dominated venlafaxine XR, with quality-adjusted life year (QALY) gains of 0.0131 and cost savings of KRW 623,229/year [US$530/year] from a limited societal perspective. Safety contributed more than efficacy to the incremental QALY gains. More patients were in recovery after initial treatment and after 1 year with vortioxetine (31%, 40%) compared to venlafaxine XR (23%, 36%). Vortioxetine remained dominant in 98% of probabilistic simulations.Conclusion: Vortioxetine dominated venlafaxine XR in South Korea and is a relevant treatment option for MDD patients initiating or switching therapy. [ABSTRACT FROM AUTHOR]

Abstract: Objective: We compared the biogenetic temperaments and characters of primary insomnia patients, major depressive disorder (MDD) patients with insomnia, MDD patients without insomnia, and normal controls. Methods: A total of 417 participants were recruited from a community and a psychiatric clinic in South Korea. Subjects were divided into 4 groups based on the Structured Clinical Interview for DSM-IV axis I disorder (SCID-IV) and sleep questionnaire: 1) normal controls (n=314), 2) primary insomnia (n=33), 3) MDD without insomnia (n=30), and 4) MDD with insomnia (n=40). All participants were requested to complete the Temperament and Character Inventory. Results: There were significant between-group differences in harm avoidance (HA)(F=32.96, p<0.001), reward dependence (RD)(F=5.21, p<0.01), self-directedness (SD)(F=24.72, p<0.001) and cooperativeness (CO)(F=15.75, p<0.001), after controlling for age and gender. Subjects with primary insomnia showed higher HA and lower SD than normal control, but lower HA and higher SD than MDD patients with insomnia. CO was lower in MDD patients, but not in subjects with primary insomnia. Lower RD was found only in MDD patients with insomnia. Conclusion: The current study suggests that high HA and low SD were related to primary insomnia, although these patterns were more prominent in patients with MDD. [Copyright &y& Elsevier]