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Introduction Previous studies have reported an association between biogenetic temperament/character and circadian preference in Spanish or French college students. Our aim is to investigate the association between temperament/character and circadian preference in psychiatrically healthy, community-dwelling Korean adults of a wide age range. Methods Subjects free of Axis I disorders ( n = 342) completed the Morningness- Eveningness Questionnaire and the Temperament and Character Inventory. Results High Novelty Seeking and low Self- Directedness was associated with eveningness. In contrast to prior studies on college students, eveningness was associated with high (not low) Harm Avoidance. Eveningness- Novelty Seeking association and Eveningness- Harm Avoidance association were prominent in females. Eveningness- Novelty Seeking was prominent in the older group (age ≥40), while Eveningness- Harm Avoidance was prominent in the younger group (age ≤40). Discussion Despite the limitation of the small sample size, the present study suggests that eveningness is associated with high Novelty Seeking/ Harm Avoidance and low Self- Directedness in community-dwelling adults, and that this association may be related to age, gender, and other sociocultural factors. [ABSTRACT FROM AUTHOR]

Purpose: We examined the prevalence, correlates, comorbidities, and suicidal tendencies of premenstrual dysphoric disorder (PMDD) according to the DSM-IV criteria in a nationwide sample of Korean women. Methods: A total of 2,499 women aged 18-64 years participated in this study. Diagnostic assessments were based on the Korean version of the Composite International Diagnostic Interview (CIDI) 2.1 and its 12-month PMDD diagnostic module, which were administered by lay interviewers. The frequencies of DSM-IV psychiatric disorders, insomnia, and suicidal tendency were analyzed among PMDD cases and compared with non-PMDD cases, and both odds ratios and significance levels were calculated. Results: The 12-month prevalence rate of DSM-IV-diagnosed PMDD was 2.4 %. Among subjects with PMDD, 59.3 % had at least one psychiatric illness; in comparison, the control frequency was 21.8 %. Associations between PMDD and alcohol abuse/dependence, major depressive disorder, post-traumatic stress disorder, social phobia, specific phobia, somatoform disorder, insomnia, and suicidality were overwhelmingly positive and significant ( p < 0.05), after controlling for age. Physical illness and being underweight were associated with increased risks of PMDD ( p < 0.05). Conclusions: PMDD was prevalent in the nationwide sample of Korean women and was frequently associated with other psychiatric disorders, insomnia, and suicidality, suggesting the need to detect and treat women who experience PMDD. [ABSTRACT FROM AUTHOR]

Aims: To date there have been no reports of long-term efficacy of aripiprazole in Asian populations. The aim of the present study was therefore to investigate the long-term efficacy, safety and tolerability of aripiprazole in a large number of patients with schizophrenia, schizophreniform disorder, or schizoaffective disorder in Korea. Methods: This study was a prospective, multicenter, single-group, 26-week open study of patients with schizophrenia, schizophreniform disorder, or schizoaffective disorder. A total of 300 Korean patients participated in the study. The primary efficacy measure was the Positive and Negative Syndrome Scale (PANSS) total score, and secondary efficacy measures included the PANSS positive and negative subscales, Clinical Global Impression–Severity of Illness (CGI-S). Tolerability and safety were assessed by monitoring the frequency and severity of treatment-emergent adverse events, extrapyramidal symptoms (EPS), vital signs, weight, and laboratory tests. Results: Aripiprazole produced rapid and significant improvements on all efficacy measures. As evidenced by PANSS total score, PANSS positive subscales and the CGI-S scores, first-episode drug-naïve patients demonstrated significantly greater efficacy relative to patients who had previously experienced one or more episodes of relapse. Aripiprazole was associated with significant decrease of serum prolactin level. The subjects showed mild weight gain. Conclusion: Aripiprazole is an effective antipsychotic in the long-term treatment of both positive and negative symptoms. This study extends the findings of previous long-term studies, and has found that there is no significant difference with regard to ethnicity in response to aripiprazole. [ABSTRACT FROM AUTHOR]

Abstract: We examined the prevalence, correlates, and comorbidities of adult attention-deficit hypersensitivity disorder (ADHD) symptoms in a Korean community using data from the National Epidemiological Survey of Psychiatric Disorders in Korea conducted in 2006. A total of 6081 subjects aged 18 to 59years participated in this study. Diagnostic assessments were based on the Adult ADHD Self-Report Scale Screener and Composite International Diagnostic Interview administered by lay interviewers. The frequencies of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) disorders, sleep disturbances, and suicidal tendency were compared in the ADHD and non-ADHD groups. Odds ratios and significance levels were calculated. The 6month prevalence of adult ADHD symptoms was 1.1%. Associations between ADHD symptoms and alcohol abuse/dependence, nicotine dependence, mood disorders, major depressive disorder, bipolar disorder, anxiety disorders, obsessive–compulsive disorder, post-traumatic stress disorder, social phobia, specific phobia, somatoform disorder, sleep disturbances, and suicidality were overwhelmingly positive and significant (P <0.05), after controlling for gender and age. Adult ADHD symptoms are highly associated with substance abuse, mood and anxiety disorders, somatoform disorders, sleep disturbances and suicidality, suggesting that clinicians should carefully evaluate and treat such psychiatric disorders in adults with ADHD symptoms. [Copyright &y& Elsevier]

Abstract: Background: Studies have consistently reported that a considerable proportion of suicidal attempts are unplanned. We have performed the first direct comparison between planned and unplanned attempts including associated methods and precipitants. Method: A total of 6510 adults, who had been randomly selected through a one-person-per-household method, completed interviews (response rate 81.7%). All were interviewed using the K-CIDI and a questionnaire for suicide. Results: Two hundred and eight subjects reported a suicide attempt in their lifetime, one-third of which had been unplanned. These individuals exhibited a lower level of education; however, no significant differences were found with regard to age, gender, marital and economic status. Further, 84.0% of unplanned attempters experienced previous suicidal ideation, experiencing their first attempt 1.9years before ideation. Additionally, 94.4% of unplanned attempters had precipitants for attempts such as familial conflict and it was also found that methods such as the use of chemical agents or falling were three times more common in unplanned than planned attempters. With respect to unplanned attempters, they exhibited a significant association with alcohol use disorder, major depressive disorder, posttraumatic stress disorder, and bipolar disorder. In particular, bipolar disorder was found to be 3.5 times higher in these individuals. Conclusions: Results have revealed that unplanned suicide attempters experience suicidal ideation and precipitants prior to their attempt. Further, attempts were associated with affective and alcohol use disorders. Therefore, in order to reduce the number of suicidal attempts, it may be useful to evaluate suicidal ideation concurrent to the treatment of existing mental disorders. [Copyright &y& Elsevier]

Objective: There is widespread recognition of the effect of physical activity on mental health. The authors examined the relationships between physical activity and mental health in a nationwide sample of Korean adults., Methods: A total of 6,510 subjects aged 18 to 64 years participated in the study. The short form of the International Physical Activity Questionnaire was used to estimate the level of physical activity. Mental health was assessed using the Composite International Diagnostic Interview, the Epidemiological Studies Depression Scale (CES-D), and the General Health Questionnaire (GHQ). Logistic regression analysis was used to compare the prevalence of CES-D and GHQ cases and psychiatric disorders among the following physical activity categories: inactive, minimally active, and health-enhancing physical activity (HEPA) active., Results: HEPA-active or minimally active subjects were less likely to be classified as "depressed" on the CES-D (≥21) and "psychologically distressed" on the GHQ (≥3) than were physically inactive subjects. HEPA was associated with a significantly decreased 1-year prevalence of major depressive disorder and obsessive-compulsive disorder, and with a significantly increased 1-year prevalence of alcohol abuse, relative to physical inactivity. In addition, HEPA was associated with a significantly increased 1 year prevalence of alcohol abuse, relative to minimal physical activity. Physical inactivity was associated with a significantly increased 1-year prevalence of alcohol dependence, relative to physical inactivity., Conclusions: The results indicate a negative association between physical activity and depressive and anxiety disorders. A high level of physical activity seems to be associated with alcohol abuse, but a moderate level of physical activity may play a role in preventing alcohol dependence., (Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.)

This was the first Korean national study to evaluate prevalence and correlates of suicidal behavior, and to compare multiple and single attempts. A total of 6510 adults completed face-to-face interviews (response rate, 81.7%) through randomly chosen one-person-per-households. Lifetime prevalence and correlates were evaluated with the Korean version of Composite International Diagnostic Interview (K-CIDI), and a questionnaire to inquire about suicidal behaviors. The lifetime prevalence of suicidal ideation, plan, and attempt in South Korea was 15.2%, 3.3%, and 3.2% (single 2.1% and multiple 1.1%), respectively. Younger age was associated with attempts and more strongly associated with multiple attempts. Attempts were the most strongly associated with mood disorders, especially bipolar disorder, which was more strongly associated with multiple attempts. In conclusion, suicidal behaviors are highly prevalent in Korea, especially in young adults. Bipolar disorder was the most strongly associated disorder with suicide attempts, more with multiple attempts.

Background: The transcriptional factors E2F1 and E2F2 have been reported to be associated with improved chemosensitivity in various cancers. We aimed to investigate whether E2F1 and E2F2 can be used as predictors of chemosensitivity in hormone-receptor-negative breast cancers (HRNBCs), which are common in Korean women., Methods: A total of 183 patients with primary breast cancer who had undergone surgical resection were evaluated on the basis of hormonal status, age, histological subtype and grade, tumor size, lymph node metastasis, and stage. The immunohistochemical expressions of E2F1 and E2F2 were analyzed for these histopathological data and patient survival., Results: E2F1 expression was associated with low histological grade (grade 1) and larger tumor size (>2 cm), while E2F2 expression was correlated only with large tumor size (>2 cm). The E2F1-positive group had less tumor recurrences, lymph node metastases during follow-up, and distant metastases than the E2F1-negative group; E2F1 expression was found to be an independent predictive factor of more favorable survival among HRNBC patients on univariate and multivariate analyses, but E2F2 expression was not., Conclusions: E2F1 may be a potential prognostic and predictive factor for clinical outcome and therapeutic results following adjuvant chemotherapy in HRNBC patients.

There have been controversial results regarding the association between brain-derived neurotrophic factor (BDNF) Val66Met polymorphism and anxiety-related traits such as harm avoidance (HA). We aimed to investigate the interaction between BDNF Val66Met polymorphism and negative life stressors in HA. BDNF Val66Met polymorphism was genotyped in 391 community-dwelling Koreans (152 males, 239 females; 43.2 +/- 14.1 years old). The Temperament and Character Inventory (TCI) and the Center for Epidemiological Studies for Depression Scale (CES-D) were self applied. The Structured Clinical Interview for DSM-IV axis I disorders and face-to-face interviews investigating negative life stressors within the last 6 months were also performed. There was no significant difference in TCI score, major depressive disorder prevalence and CES-D score among the 3 genotypes (94 Met/Met, 188 Val/Met and 109 Val/Val subjects). There was no significant difference in TCI scores between subjects with stressors and those without stressors, while more common major depressive episodes (p = 0.03) and higher CES-D scores (p < 0.001) were found in subjects with stressors. However, there was a significant interaction between the BDNF genotype and negative life stressors in HA (p = 0.02). Only subjects with the Val/Val genotype showed higher HA with recent negative stressors. Our finding suggests that BDNF Val66Met polymorphism might influence HA by interacting with recent negative stress experience., ((c) 2009 S. Karger AG, Basel.)

Study Objectives: Conflicting reports on prevalence of RLS exist in Asian countries due to differences in sampling strategies and assessment instruments. We assessed the prevalence, correlates, quality of life, and psychiatric comorbidity of RLS in South Korea., Design/setting: Cross-sectional nationwide survey., Participants: Nationally representative sample of 6,509 Korean adults aged 18-64., Measurement & Results: Face-to-face interviews based on the Korean translation of the four features of RLS defined by the International RLS Study Group (IRLSSG), the Korean version of Composite International Diagnostic Interview (K-CIDI), and EuroQol (EQ-5D) were conducted for all participants. The weighted prevalence of RLS in South Korea was 0.9% (men, 0.6%; women, 1.3%). Subjects with RLS had a lower quality of life according to EQ-5D than those without RLS. Adjusted odds ratio for lifetime diagnosis of DSM-IV major depressive disorder (2.57, 95% confidence interval [1.33, 4.96]), panic disorder (18.9 [4.72, 75.9]) and posttraumatic stress disorder (3.76 [1.32, 10.7]) suggest strong association between RLS and DSM-IV depression and anxiety disorders., Conclusions: Prevalence of RLS estimated based on the IRLSSG diagnostic criteria is substantially lower in South Korea than in Western countries. Differences in culture and risk factors that affect the expression of RLS may vary across the countries.

The Montreal Cognitive Assessment (MoCA) is a brief cognitive screening tool with high sensitivity for screening patients with mild cognitive impairment (MCI). The authors examined the validity and reliability of the Korean version of the MoCA (MoCA-K) in elderly outpatients. The MoCA-K, a Korean version of the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR) scale, and neuropsychological batteries were administered to 196 elderly persons (mild Alzheimer's disease [AD] = 44, MCI = 37, normal controls [NC] = 115). MoCA-K scores were highly correlated with those of MMSE and CDR. Using a cutoff score of 22/23, the MoCA-K had an excellent sensitivity of 89% and a good specificity of 84% for screening MCI. Internal consistency and test-retest reliability were good. The results obtained show that the MoCA-K is brief, reliable, and suitable for use as a screening tool to screen MCI patients in elderly outpatient clinic settings.

This study estimates the treated prevalence of schizophrenia and the annual costs associated with the illness in Korea in 2005, from a societal perspective. Annual direct healthcare costs associated with schizophrenia were estimated from National Health Insurance and Medical Aid records. Annual direct non-healthcare costs were estimated for incarceration, transport, community mental health centers, and institutions related to schizophrenia. Annual indirect costs were estimated for the following components of productivity loss due to illness: unemployment, reduced productivity, premature mortality, and caregivers' productivity loss using a human capital approach based on market wages. All costs were adjusted to 2005 levels using the healthcare component of the Consumer Price Index. The treated prevalence of schizophrenia in 2005 was 0.4% of the Korean population. The overall cost of schizophrenia was estimated to be $ 3,174.8 million (3,251.0 billion Won), which included a direct healthcare cost of $ 418.7 million (428.6 billion Won). Total direct non-healthcare costs were estimated to be $ 121 million (123.9 billion Won), and total indirect costs were estimated at $ 2,635.1 million (2,698.3 billion Won). Unemployment was identified as the largest component of overall cost. These findings demonstrate that schizophrenia is not rare, and that represents a substantial economic burden.

Objective: In Korea, human placental extract (HPE) has recently been used to treat various diseases (chronic liver diseases, menopause syndrome, chronic fatigue, skin pigment diseases, etc.), but evidence-based studies are not yet sufficient. The aim of this study was to examine the effects of HPE on menopausal symptoms, fatigue, and risk factors for cardiovascular disease in middle-aged Korean women in a randomized controlled trial., Design: Korean women, aged 40 to 64 years, with menopausal symptoms and fatigue were recruited as participants. The women were randomly assigned to a placebo group or an HPE group. The HPE group received subcutaneous injections of HPE in the abdomen for 8 weeks, whereas the placebo group received normal saline. Then, the Menopause Rating Scale, and Fatigue Severity Scale, and Visual Analog Scale were administered, and risk factors for cardiovascular disease were assessed., Results: The Menopause Rating Scale total baseline score was not different between the two groups; however, the score of the HPE group decreased significantly at 8 weeks compared with that of the placebo group (P = 0.033). Fatigue Severity Scale and Visual Analog Scale scores of the placebo group did not change, whereas the scores of the HPE group decreased significantly during the study period (Fatigue Severity Scale, P = 0.002; Visual Analog Scale, P = 0.001). The baseline 17beta-estradiol level was not significantly different between the two groups, but the 17beta-estradiol level of the HPE group was significantly increased at 8 weeks compared with that of the placebo group (P = 0.031). No changes in risk factors for cardiovascular disease were observed in either group., Conclusions: Menopausal symptoms and fatigue in middle-aged Korean women improved after 8 weeks of HPE treatment, whereas risk factors for cardiovascular disease did not change during the study period.

The objective was to estimate the prevalence and correlates of psychiatric disorders in a nationwide sample of Korean adults. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview 2.1/DSM-IV (N = 6275, response rate 79.8%). The lifetime and 12-month prevalences for all types of DSM-IV disorders were 33.5% and 20.6%, respectively. Those of specific disorders were as follows: 17.2% and 7.1% for alcohol use disorder, 11.2% and 7.4% for nicotine use disorder, 5.2% and 4.2% for specific phobia, 4.3% and 1.7% for major depressive disorder, and 2.3% and 1.0% for generalized anxiety disorder. Among the sociodemographic variables, widowed status, higher income, and rural residence were the risk factors for both lifetime major depressive disorder and alcohol use disorder after controlling for gender, age, and education. The prevalence of psychiatric disorders was higher than those observed in other East-Asian countries and most European countries, but lower than that in the United States. Alcohol use disorder was particularly high in Korea.

A few studies have been conducted on the prevalence of partial posttraumatic stress disorder (PTSD), but points of agreement and disagreement between full and partial PTSD have not been fully investigated. We interviewed a representative sample of 6,258 subjects, ages 18-64 years, in household visits using the Korean version of the Composite International Diagnostic Interview (K-CIDI 2.1). "Partial PTSD" was defined as >/=1 symptom in each of the three symptom groups (Criteria B, C, and D) and duration of >/=1 month (Criterion E). Estimated lifetime prevalence of partial PTSD was 2.7%, and that of full PTSD was 1.7%. A "female gender" risk factor was significantly associated with both partial and full PTSD. The mean duration of partial PTSD was 6.5 years, which was not significantly different from the 5.7 year duration of full PTSD. Traumas associated with the development of partial rather than full PTSD were "natural disaster with fire" and "military combat" in men, and "witnessing a traumatic situation" and "learning about traumas to others" in women, whereas "threatened by others" was more associated with the development of full PTSD. The rates of multiple comorbid disorders and of comorbid major depressive disorder and dysfunctions in work during the 1-month period prior to interview did not differ significantly between the partial and full PTSD groups. In conclusion, partial PTSD did not differ significantly from full PTSD in terms of duration, comorbidity, and dysfunction, but they differed markedly in terms of associated trauma types.

Purpose: The aim of this study was to evaluate health-related quality of life (HRQOL) in breast cancer patients across countries, and to cross-culturally examine the impact of psychosocial factors on HRQOL., Patients and Methods: A total of 413 women with breast cancer from Germany (n = 195), Japan (n = 112), and Korea (n = 106) completed a survey assessing HRQOL and HRQOL-related factors. HRQOL was measured using the Short-Form Health Survey (SF-8). Measures of psychological distress (Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised), coping (Dealing with Illness Inventory-German Revised), and social support (Illness-Specific Social Support Scale-German Revised) were included., Results: The effect of the factor country on physical QOL was seen to be significant, but small (P = 0.049, ES = 0.018). The scales of General Health (P = 0.023), Vitality (P = 0.004), and Role Emotional (P = 0.003) differed across countries, with the South Korean patients having lower scores compared to the German and Japanese patients. The nature of the impact of psychosocial factors on HRQOL did not differ greatly across countries except with regard to avoidance, however, the degree to which these factors influence HRQOL did differ greatly. Overall, depression, depressive coping, and problematic support showed a strong detrimental effect on the HRQOL of breast cancer patients., Conclusions: Results from this study suggest that strategies which target an improvement of HRQOL in cancer patients should also consider the patients' cultural and healthcare system contexts. Interventions are needed to improve detrimental psychosocial factors.

Hepatocellular carcinoma (HCC) is one of the most prevalent gastrointestinal malignant tumors in Southeast Asia. Thirty-one cirrhotic HCC, 14 noncirrhotic HCC, and 13 metastastic HCC in the Korean population were investigated on microdissected tissues for chromosomal aberrations by degenerate oligonucleotide-primed polymerase chain reaction (PCR) comparative genomic hybridization. A number of prominent sites of genomic imbalances were observed. The gains of 1q, 6p, 7, 8q, 12q, 13q3-q32, 16p, 17q, and 20q and the losses of 1p, 4q, 6q, 8p, 9p, and 13q regions were observed with a similar high frequency in all types. Various chromosomal aberrations were observed preferentially to specific types. Gains of 4p15-pter, 10q24-qter, 18p11-pter, and 19p10-pter and a loss of 11q14-q22 were observed in the cirrhotic HCC, whereas losses of 14q21-q23 and 10q22-q23 were observed in noncirrhotic HCC. In metastatic HCC, gains of 3q25-qter and Xp21-pter and losses of 21q11-qter and Y were observed. The recurrent gains and losses of chromosomal regions identified in this study are consistent with several previous observations and provide possible candidate regions for the involvement of tumorigenesis and progressions of HCC.

Bronchiolitis obliterans organizing pneumonia (BOOP) is a clinicopathological syndrome associated with a variety of disease entities. The aim of this study was to review cases with initial diagnosis of BOOP applying uniform histopathologic criteria, and analyze the clinical characteristics of proven cases of BOOP including rapidly progressive form. A total of 81 cases, initially diagnosed as BOOP and with available tissue sections, was collected. Thirty six cases (44.4%) were excluded from the study, more than two thirds of which were given a revised diagnosis of interstitial pneumonitis/fibrosis other than BOOP. Thirty one patients were classified as idiopathic BOOP, 8 patients as secondary BOOP, and 6 patients as rapidly progressive BOOP. Open lung biopsy specimen from all six cases with lethal outcome showed more severe interstitial inflammation and septal fibrosis and/or alveolar exudate with a varying degree than those with good prognosis. There was no difference by the sexes. The two most frequent presenting symptoms were cough and dyspnea. Bilateral multifocal consolidation was a common radiological finding. More than 70% cases of idiopathic BOOP experienced clinical improvements. The diagnosis of BOOP is usually suggested by clinicoradiologic findings, but needs to be confirmed histopathologically, preferably through surgical open or video-assisted thoracoscopic biopsy.