Hae Woo Lee

Impulsivity in Internet Addiction: A Comparison with Pathological Gambling

Internet addiction has been considered to be associated with poor impulse control. The aim of this study is to compare the trait impulsivity of those suffering from Internet addiction with that of individuals suffering from pathological gambling. Twenty-seven patients diagnosed with Internet addiction (age: 24.78±4.37 years), 27 patients diagnosed with pathological gambling (age: 25.67±3.97 years), and 27 healthy controls (age: 25.33±2.79 years) were enrolled in this study. All patients were men seeking treatment. Trait impulsivity and the severity of the Internet addiction and pathological gambling were measured by the Barratt Impulsiveness Scale-11, the Youngs Internet Addiction Test, and the South Oaks Gambling Screen, respectively. The Beck Depression Inventory and the Beck Anxiety Inventory were also administered to all subjects. Our results show that those suffering from Internet addiction showed increased levels of trait impulsivity which were comparable to those of patients diagnosed with pathological gambling. Additionally, the severity of Internet addiction was positively correlated with the level of trait impulsivity in patients with Internet addiction. These results state that Internet addiction can be conceptualized as an impulse control disorder and that trait impulsivity is a marker for vulnerability to Internet addiction.

Lifetime Prevalence and Correlates of Suicidal Ideation, Plan, and Single and Multiple Attempts in a Korean Nationwide Study

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.

Unplanned versus planned suicide attempters, precipitants, methods, and an association with mental disorders in a Korea-based community sample

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 1.9 years 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.

Relationships of sleep duration with sociodemographic and health-related factors, psychiatric disorders and sleep disturbances in a community sample of Korean adults

The aim of this study is to examine relationships of sleep duration with sociodemographic and health‐related factors, psychiatric disorders and sleep disturbances in a nationwide sample in Korea. A total of 6510 subjects aged 18–64 years participated in this study. Logistic regression was used to calculate the odd ratios and 95% confidence intervals of the covariates, psychiatric disorders and sleep disturbances across the following sleep duration categories: 5 h or less, 6, 7, 8 and 9 h or more per day. Low levels of education, unemployment and physical illness were associated with sleeping for 5 h or less and 9 h or more. Being older and widowed/divorced/separated, high levels of physical activity, pain/discomfort, obesity and high scores on the General Health Questionnaires were associated with sleeping for 5 h or less. Female, being younger and underweight were associated with sleeping for 9 h or more. Alcohol dependence, anxiety disorder and social phobia were associated significantly with sleeping for 5 h or less and 9 h or more. Other psychiatric disorders were more common in subjects who slept for 5 h or less (e.g. alcohol use disorder, mood disorder, major depressive disorder, dysthymic disorder, obsessive‐compulsive disorder and specific phobia) or 9 h or more (e.g. post‐traumatic stress disorder). In addition, subjects who slept for 5 h or less reported more sleep disturbances than did subjects who slept for 7 h. Short or long sleep is associated with psychiatric disorders and/or sleep disturbance, therefore attention to the mental health of short or long sleepers is needed.

The 12-Item General Health Questionnaire as an Effective Mental Health Screening Tool for General Korean Adult Population

Objective The 12-item General Health Questionnaire (GHQ-12) has been used extensively in various settings across different cultures. This study was conducted to determine the thresholds associated with optimum sensitivity and specificity for the GHQ-12 in Korean adults. Methods Data was acquired from a sample of 6,510 Korean adults, ages 18 to 64 years old, who were selected from the 2005 Census (2,581 men and 3,929 women). Participants completed the GHQ-12 and the Korean Composite International Diagnostic Interview (K-CIDI). Receiver Operating Characteristic (ROC) curve analysis was conducted. Results The mean GHQ-12 score for the total sample was 1.63 (SD 1.98). The internal consistency of the GHQ-12 was good (Cronbachs α=0.72). Results from the ROC curve indicated that the GHQ-12 yielded greater accuracy when identifying mood and anxiety disorders than when identifying all mental disorders as a whole. The optimal threshold of the GHQ-12 was either 1/2 or 2/3 point depending on the disorder, but was mainly 2/3. Conclusion The Korean version of the GHQ-12 could be used to screen for individuals at high risk of mental disorders, namely mood and anxiety disorders.

Rapid-Onset Hyponatremia Induced by Duloxetine in a Middle-Aged Male with Depression and Somatic Symptoms

Duloxetine is a relatively balanced selective serotonin and noradrenaline reuptake inhibitor. We report a case of hyponatremia induced by duloxetine developed rapidly after starting the medication in a middle-aged male with multiple somatic symptoms and depression. Two days after discontinuation of duloxetine and management with hypertonic saline as well as fluid restriction, the serum sodium level normalized. The patient had two risk factors for developing hyponatremia, such as severe body weight loss and pneumonia. Therefore, when treating patients with depression and somatic symptoms, especially with risk factors for developing hyponatremia, close monitoring for clinical and laboratory evidence of hyponatremia may be essential.

The association between psychiatric disorders and work-related problems among subway drivers in Korea

ObjectivesThis study aimed to find the prevalence and occupational risk factors for major psychiatric disorders among subway drivers in South Korea.MethodsOf all 998 current subway drivers, 995 participated in this study. The Korean version of the Composite International Diagnostic Interview (K-CIDI 2.1) was administered by trained interviewers to diagnose psychiatric disorders in all participants. The questions on socio-demographic characteristics and working conditions included some questions related to a person under train (PUT) experience and work-related problems. One-year prevalence and lifetime prevalence of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and panic disorder were diagnosed through the interview. The standardized prevalence ratios (SPRs) of these three disorders were calculated in the sample of subway drivers using the 2011 Korean National Epidemiologic Survey data as a basis. Multiple logistic regressions were performed to determine the association between work-related factors and the prevalence of the psychiatric disorders.ResultsThe standardized prevalence ratios (SPRs) for a 1-year prevalence of MDD and PTSD among subway drivers were 1.1 (95% CI 0.7-1.7) and 5.6 (95% CI 3.1-8.8), respectively. Conflict with passengers was significantly associated with an increased risk for both MDD and PTSD in 1-year and in lifetime prevalence. Experiencing a sudden stop due to an emergency bell increased the risk of the lifetime prevalence of MDD (OR 2.61, 95% CI 1.14-6.97) and PTSD (OR 7.53, 95% CI 1.77-32.02). The risk of PTSD significantly increased among drivers who once experienced a near accident in terms of both the 1-year prevalence (OR 8.81, 95% CI 1.96-39.3) and the lifetime prevalence (OR 6.36, 95% CI 2.40-16.90).ConclusionsPTSD and panic disorder were more prevalent among subway drivers than in the general population. We found that having a conflict with passengers, a near accident, and a breakdown while driving can be risk factors for psychiatric disorders among subway drivers. Therefore, a prompt and sensitive approach should be introduced for these high risk groups within the subway company.

Comparison of treated and untreated alcohol dependence in a nationwide sample of Korean adults

We examined factors associated with lifetime treatment of alcohol dependence in a nationwide sample of Korean adults. Of the 6510 respondents, aged 18–64, who participated in the Korean Epidemiologic Catchment Area study, we analyzed 458 who had a lifetime diagnosis of alcohol dependence. Lay interviewers administered a diagnostic assessment, based on the Korean version of the Composite International Diagnostic Interview, to each of the respondents. Of the 458 respondents with a lifetime diagnosis of alcohol dependence, 55 (12.0%) had been treated for psychiatric problems. Treated alcohol-dependent respondents were less likely to have a stable, dyadic relationship or a full-time job. In addition, they were more likely to have experienced alcohol withdrawal symptoms, given up important activities because of alcohol use, and continued alcohol use despite knowing they had an alcohol-associated physical or psychological problem and were less likely to have spent a great deal of time obtaining or drinking alcohol or recovering from its effects. Treated individuals were also more likely to have comorbid mood disorders, especially major depressive disorder, or comorbid anxiety disorders, especially post-traumatic stress disorder, social phobia, or obsessive–compulsive disorder. Alcohol-dependent persons significantly underuse mental health services. Patterns of alcohol use and comorbid psychiatric disorders, as well as socio-demographic factors, affected treatment-seeking by alcohol-dependent individuals in Korea.