Chang-In Lee

Caregiver burden among caregivers of Koreans with dementia.

Background: Most studies on caregiver burden have been conducted in Western countries, while few studies on the correlates of caregiver burden have been performed in Korea. Objective: To suggest better policies for the care of dementia patients by using a nationwide database to identify factors that affect caregiver burden in Korea. Methods: The database of the Korean National Health Insurance (KNHI) and National Medical Aid (NMA) programs, which covers all Koreans, was used. A sample of 609 dementia patients and their caregivers was selected from a total of 85,281 dementia patients in 2004 and interviewed to evaluate the total cost of care and caregiver burden. Stepwise multiple linear regression analysis was then performed to identify significant independent predictors of caregiver burden. Results: Among caregiver-related factors, caregiver burden was higher in those who were female, had a history of home care during the previous year, and had less education. Among patient-related factors, poor ADL/IADL function was significant. The most interesting result was that subjective sense of socioeconomic status (good/fair/poor) was a stronger predictor of caregiver outcome than actual economic costs. Conclusion: The results of this study suggest that interventions to assist patients with dementia should focus on female caregivers, especially those considered likely to be suffering from an economic burden. Interventions should also aim to improve the ADL and IADL capacities of patients.

Prevalence of depression and correlates of depressive symptoms for residents in the urban part of Jeju Island, Korea

Aims: This study examined the prevalence of depression and depressive symptoms, and the correlates of depressive symptoms, and proposes some methods for reducing risk of depression in residents of the urban part of Jeju Island in Korea. Methods: In all, 1050 residents were selected using multiphasic cluster sampling to represent each district. Of the 981 respondents, 413 were men and 568 were women. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to evaluate depression (CES-D score over 25) and depressive symptoms (CES-D score over 21). Multiple logistic regression analysis was performed for comparisons. Results: The prevalence of depression in males and females was comparable, at 9.47 and 11.36%, respectively. The prevalence of depressive symptoms in men was 15.01%, while in women the level rose to 18.37%. Those with high self-assessed level of stress scores were significantly more likely to have depressive symptoms than those with low self-assessed level of stress scores (odds ratio (OR) = 5.73 (95% confidence interval (95%CI), 1.29–25.36)). Residents at high risk of problem drinking (CAGE score over 3) were significantly more likely to have depressive symptoms than those with a CAGE score under 1 (OR = 3.43 95%CI, 1.77–6.66). Respondents who slept poorly had more depressive symptoms than respondents who slept well (OR = 2.11 95%CI, 1.37–3.23). Females were significantly more likely to have more depressive symptoms than males (OR = 1.70 95%CI, 1.08–2.68). Conclusions: The prevalence of depression and depressive symptoms in urban Jeju Island is similar to that in a nation-wide sample. By providing intensive mental health services to those who have high stress levels, problem drinking, and poor health behavior, early detection of depressive symptoms in the community will be important for improving general health status.

Prevalence and Correlates of Depressive Symptoms among North Korean Defectors Living in South Korea for More than One Year

Objective This study examined the prevalence and correlates of depressive symptoms in North Korean defectors who have been living in South Korea for more than one year. Methods We used questionnaires developed by the authors to collect sociodemographic data in addition to the Center for Epidemiologic Studies Depression Scale (CES-D), the Psychosocial Well-being Index to measure stress, and a social support scale. A total of 367 subjects were included in this study. Results The results showed that 30.5% of the men and 34.7% of the women reported depressive symptoms, and 33.1% of the men and 36.1% of the women exhibited signs of severe distress. Correlates of depressive symptoms were lack of occupation [odds ratio (OR)=2.198, 95% confidence interval (CI), 1.247-3.873], having escaped without family (OR=1.725, 95% CI, 1.006-2.959), and a poor subjective sense of health status (OR=3.111, 95% CI, 1.591-6.085). Conclusion Continuing vocational training and career management, psychological support programs, and intensive physical health services are needed to improve the mental health of this population.

The Relationship between Cognitive Decline and Psychopathology in Patients with Schizophrenia and Bipolar Disorder

Objective The primary goals of the present study were to assess intellectual function in participants with schizophrenia or bipolar disorder (BD) and to investigate the relationships between cognitive decline and the severity of each type of psychopathology. Methods The present study included 51 patients with schizophrenia and 42 with BD who were recruited from the psychiatry outpatient clinic of Jeju University Hospital between March 2011 and March 2014. The Korean Wechsler Adult Intelligence Scale (K-WAIS) was administered to each of the 93 participants, and they were categorized into two groups based on their current intelligence quotient (IQ) and their estimated premorbid IQ: severely impaired group (SIG) and mildly impaired group (MIG). The Minnesota Multiple Personality Inventory (MMPI) and the Brief Psychiatric Rating Scale (BPRS) were used to assess psychopathology. Results The SIG schizophrenia participants exhibited significantly higher scores on the frequent (F) and schizophrenia (Sc) subscales of the MMPI, but significantly lower scores on the correction (K) and psychopathic deviate (Pd) subscales compared with the MIG schizophrenia participants. Furthermore, the BPRS scores were significantly higher in the SIG schizophrenia participants relative to the MIG schizophrenia participants. The SIG BD participants had significantly higher F, masculinity-femininity (Mf), paranoia (Pa), and Sc but significantly lower Pd scores compared with the MIG BD participants. Conclusion The present findings revealed a significant discrepancy between the estimated premorbid levels of cognitive function and current cognitive function in participants with schizophrenia or BD. Moreover, this discrepancy was correlated with severity of psychopathology in both groups.

Prevalence of distorted body image in young Koreans and its association with age, sex, body weight status, and disordered eating behaviors

Purpose To define the prevalence of distorted body image in 10–24-year-old Koreans and determine its relationship with sex, age, body weight status, and disordered eating behaviors. Methods A total of 3,227 young Koreans were recruited from elementary, middle, and high schools, as well as from universities. The participants completed a self-reported questionnaire on body image, eating behaviors (Eating Attitude Test-26), and body weight status. Results The prevalence of a distorted body image in males was 49.7% and that in females was 51.2%. Distorted body image was more frequent in adolescents (age, 10–17 years) than in young adults (age, 18–24 years). The highest prevalence (55.3%) was reported in female elementary school students (age, 10–12 years). Distorted body image was associated with disordered eating behaviors and abnormal body weight status. Conclusion These results suggest that distorted body image is a public health problem, given its high frequency in young Koreans, and that it is associated with abnormal body weight status and disordered eating behaviors.

The prevalence of bipolar spectrum disorder in elderly patients with recurrent depression

Purpose Despite a growing body of knowledge on bipolar spectrum disorder (BSD), relatively little is known about the clinical characteristics of BSD in elderly people. We investigated the prevalence of BSD in elderly patients with recurrent depression. Patients and methods A total of 65 elderly outpatients (≥60 years of age) who met the Diagnostic and Statistical Manual of Mental Disorders IV criteria for recurrent major depressive disorder participated in the study. BSD was diagnosed according to the criteria developed by Ghaemi et al and the Mood Disorder Questionnaire (MDQ) was used to assess bipolarity. Results Of 65 subjects, eleven (16.9%) and 54 (83.1%) were diagnosed with BSD and unipolar depression, respectively. A total of 32.3% (n=22) had a positive screen for bipolar disorder, and we found a significant association between the BSD criteria and the criteria for a positive MDQ (P<0.001). Patients with BSD had a longer duration of illness (P=0.040) and more prior depressive episodes (P<0.001) than did those with unipolar depression. The BSD criteria of first-degree relative with bipolar disorder (P=0.030), antidepressant-induced hypomania (P=0.034), hyperthymic personality (P=0.001), and atypical depression (P=0.030) were highly associated with MDQ-positive patients. Conclusion Our results indicate that many depressed elderly patients have bipolar-related illness; moreover, some features of the depression are associated with bipolarity.

Differences of neuropsychological function and behavioral symptoms between depressive elderly patients with or without subjective memory complaint

loss should reveal limbic system dysfunction and loss of valence association to cognitive information. Methods: To counterpart the miss of test sensitivity and to bring to light this early symptom, we proposed: (1) to evaluate separately inhibition and then inhibition-emotion efficiencies in comparing 10 early AD (MMSE 1⁄4 21-26, mean age 1⁄4 80), 10 old (mean age 1⁄4 79) and 10 young adults (mean age 1⁄4 23) on Standard and Emotional Stroop (emotion perception), (2) to control the incidence of individual efficiency on cognition, using the NEPSY neuropsychological test (Korkman et al., 1998), on emotion with the Multiple Emotional Intelligence Scale (Mayer & Salovey, 1997) on depression-apathy and socio-educational level. If affect loss severely diminishes somatic marking of cognitive information, AD capacity of inhibition will not be affected by emotional valence associated to information. Results: The initial results indicate a relative increase of errors number between Standard et Emotional Stroop from AD patients to young adults but no reaction time differences. Conversely, emotional sensibility differs between young adults and AD patients, depending on emotion perception, understanding and regulation. Executive functions vary at intergroup and intragroup levels. Individual results are, actually, explored in function of these three indicators and will be presented, as influence of positive and negative valence. Conclusions: More generally, if AD cognitive-emotional damage can be easily demonstrated, the degree of validity of early diagnostic of AD will increase, treatments will begin earlier and capacity to report enter in severe phase of AD will increase, too. This progress could benefit to patients, caregivers and Public Health.

P3-452: Differences of cognitive functions and activity of daily living according to presence of depressive symptoms among dementia patients

more depressed. A significant interaction was found between cognitive group and neuropsychiatric symptoms, such that the strength of the association between care recipient neuropsychiatric symptoms and caregiver depression was strongest for the cognitively impaired not demented group. Conclusions: These result provide further evidence of the association of care recipient neuropsychiatric symptoms and caregiver depression in Latinos. Caregivers of Latino elderly who are cognitively impaired may be particularly vulnerable to depression in the face of high care recipient neuropsychiatric symptoms.