Hong Jin Jeon

Brief Screening for Mild Cognitive Impairment in Elderly Outpatient Clinic : Validation of the Korean Version of the Montreal Cognitive Assessment

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 Alzheimers 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.

Lifetime and 12-month prevalence of DSM-IV psychiatric disorders among Korean adults.

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.

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.

Prevalence, correlates, and comorbidities of adult ADHD symptoms in Korea: Results of the Korean epidemiologic catchment area study

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 59 years 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 6 month 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.

The Prevalence and Impact of Depression Among Medical Students: A Nationwide Cross-sectional Study in South Korea

Purpose This nationwide cross-sectional study assessed the prevalence, possible risk factors, and impact of depression among Korean medical students. Method Of all medical students (14,095) registered in 41 medical schools in 2006 in South Korea, 7,357 (52.2%) completed the survey. Depression was measured using the patient-rated version of the Mini International Neuropsychiatric Interview (MINI-PR). Data on academic functioning, and sociodemographic characteristics were also obtained. Results Current, one-year, and lifetime prevalence of major depressive disorder (MDD) were 2.9%, 6.5%, and 10.3%, respectively. Possible risk factors for one-year MDD were female gender, lower class years, admission track with exemption from entrance exam, living alone at a lodging house or a rented room, and financial difficulty (P < .05). The grade point averages (GPAs) of students with MDD were significantly lower than those of nondepressed students for both semesters (t = 3.8, P < .001; t = 4.8, P < .001). The odds ratio of students with MDD of receiving a GPA below 2.0 was 1.8 (CI 1.4–2.4) as compared with nondepressed students. Conclusions This study demonstrated that Korean medical students experience depression frequently. It also highlighted the possible risk factors of MDD among medical students and pervasive association of depression with poor functioning.

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.

Early trauma and lifetime suicidal behavior in a nationwide sample of Korean medical students

BACKGROUND No previous study has investigated the association between early trauma and suicidal behavior in medical students. We evaluated the types of early trauma which are the most strongly associated with a lifetime history of suicidal behavior in medical students. METHOD A total of 6986 medical students completed a self-administered questionnaire (response rates: 49.6% of the entire medical student body in Korea) which included lifetime suicidal behavior, stressors, and the Early Trauma Inventory Self Report-Short Form (ETISR-SF). This was used to evaluate the most serious forms of trauma experienced before the age of 18, including general trauma, physical, emotional and sexual abuse. RESULTS Among medical students, lifetime prevalence of suicidal behavior was 34.0% for those who experienced early trauma and 18.1% in those without a history of trauma (chi(2)=215.7, p<0.0001). Emotional abuse exhibited a higher odds ratio for lifetime suicidal behavior (OR=3.6, 95%CI=2.9-4.4) than other traumas including general trauma (OR=2.1, 95%CI=1.8-2.4), sexual (OR=2.0, 95%CI=1.5-2.8) or physical (OR=1.8, 95%CI=1.5-2.1) abuse, and current stressors including heavy stress (OR=1.5, 95%CI=1.4-1.8), poor physical health (OR=1.3, 95%CI=1.2-1.5), and poor economic status (OR=1.2, 95%CI=1.0-1.3). Emotional abuse also showed a higher odds ratio for lifetime suicidal ideation (OR=3.5, 95%CI=2.8-4.4), plan (OR=3.9, 95%CI=2.4-6.2), and attempt (OR=4.1, 95%CI=2.4-6.8) than other early traumas or stressors. In emotional abuse, a continuously cold or uncaring parental attitude exhibited a stronger association with lifetime suicidal behavior (OR=4.5, 95%CI=2.7-7.7) than other emotional abuse. CONCLUSION Emotional abuse, especially continuous parental emotional abuse in childhood, is significantly associated with lifetime suicidal behavior in Korean medical students.

Prevalence of DSM-IV major mental disorders among Korean adults: A 2006 National Epidemiologic Survey (KECA-R)

OBJECTIVES The aim of this study was to estimate the prevalence of the DSM-IV major mental disorders in the Korean population using the Korean version of Composite International Diagnostic Interview (K-CIDI). METHODS The Korean Epidemiologic Catchment Area study Replication (KECA-R) was conducted between August 2006 and April 2007. The sampling of the subjects was carried out across 12 catchment areas using a multistage, cluster sampling design. The target population included all eligible community dwelling residents aged 18-64 years. Face-to-face interviews were conducted using the K-CIDI based on the DSM-IV. RESULTS A total of 6510 participants completed the interview (response rate=81.7%). The lifetime and 12-month prevalence rates for DSM-IV major mental disorders were 29.0% and 16.9%, respectively. Those of specific disorders were as follows: (1) alcohol use disorder, 16.2% and 5.6%; (2) nicotine use disorder, 9.0% and 6.0%; (3) specific phobia, 3.8% and 3.4%; (4) major depressive disorder, 5.6% and 2.5%; and (5) generalized anxiety disorder, 1.6% and 0.8%. Additionally, data related to nicotine and alcohol use disorder revealed a very high male to female ratio. Further, mood and anxiety disorders were more prevalent in females than in males. CONCLUSION The prevalence of major mental disorders was high. In comparison with the studies performed in other countries, notable differences were observed with respect to the distribution of mental disorders in Korea.

Depression and the vision-related quality of life in patients with retinitis pigmentosa

Aims: To assess the relationship between depression and the vision-related quality of life in patients with retinitis pigmentosa (RP). Methods: The study included 144 patients diagnosed as having RP. The mean age of the patients was 38.5 (SD 13.3) years, and 42% of the subjects were women. They answered the National Eye Institute Visual Function Questionnaire (NEI-VFQ) to assess the vision-related quality of life and the Beck Depression Inventory (BDI) to assess depressive symptoms. Patients were classified into groups with and without depression according to the BDI score. The NEI-VFQ composite and subscale scores were compared between groups. The correlations between the BDI and the NEI-VFQ, weighted visual acuity (WVA) and functional vision score (FVS) were investigated. Results: The depressed group had significantly less subjective visual function compared with the non-depressed group. A negative correlation was observed between the BDI and the NEI-VFQ scores, while no correlation was found between the BDI score and WVA or FVS. Conclusion: The RP patients with depression had poorer vision-related functions compared with those patients without depression, which cannot be explained by the visual acuity. Interventions to diagnose and treat depression are necessary to enhance the overall quality of life in RP patients.