Young-Eun Jung

Prevalence and correlates of attention-deficit hyperactivity disorder symptoms in Korean college students

Background Attention-deficit hyperactivity disorder (ADHD) persists into adulthood in a high proportion of cases, causing social difficulties and affective problems. We evaluated the prevalence of symptoms of ADHD and the correlates thereof in Korean college students. Methods A total of 2,172 college students, stratified to reflect geographical differences, were asked to complete self-report questionnaires on ADHD symptoms, depression, and related factors. Results ADHD symptoms were found in 7.6% of college students. Univariate analysis revealed that younger students had higher rates of ADHD symptoms than did older students. We found significant associations between ADHD symptoms and problematic alcohol use, depression, and lifetime suicidal behavior. Multivariate analysis revealed that ADHD symptoms in adults were significantly associated with depression (odds ratio [OR] =4.69; 95% confidence interval [CI] 3.23–6.80; P<0.001) and overweight or obesity (OR =1.50; 95% CI 1.02–2.22; P=0.040), after controlling for sex and age. Conclusion These results have implications in terms of the mental health interventions required to assess problems such as depression, alcohol use, obesity, and suicidality in young adults with ADHD symptoms.

One-year rehospitalization rates of patients with first-episode bipolar mania receiving lithium or valproate and adjunctive atypical antipsychotics

We compared the 1‐year rehospitalization rates of first‐episode bipolar manic patients who were discharged while being treated with lithium or valproate in combination with an atypical antipsychotic.

Adjunctive Low-frequency Repetitive Transcranial Magnetic Stimulation over the Right Dorsolateral Prefrontal Cortex in Patients with Treatment-resistant Obsessive-compulsive Disorder: A Randomized Controlled Trial

Objective The present study aimed to evaluate the efficacy of low frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the right dorsolateral prefrontal cortex (DLPFC) for the treatment of obsessive-compulsive disorder (OCD). Methods Twenty-seven patients with treatment resistant OCD were randomly assigned to 3 week either active (n=14) or sham (n=13) rTMS. The active rTMS parameters consisted of 1 Hz, 20-minute trains (1,200 pulses/day) at 100% of the resting motor threshold (MT). OCD symptoms, mood, and anxiety were assessed at baseline and every week throughout the treatment period. Results A repeated-measures analysis of variance (ANOVA) was used to evaluate changes on the Yale-Brown Obsessive Compulsive Scale (YBOCS). Our results revealed a significant reduction in YBOCS scores in the active group compared with the sham group after 3 weeks. Similarly, a repeated-measures ANOVA revealed significant effect of time and time×group interaction on scores on the Hamilton Depression Rating Scale and the Clinical Global Impression-Severity scale. There were no reports of any serious adverse effects following the active and sham rTMS treatments. Conclusion LF rTMS over the right DLPFC appeared to be superior to sham rTMS for relieving OCD symptoms and depression in patients with treatment-resistant OCD. Further trials with larger sample sizes should be conducted to confirm the present findings.

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.

Factors associated with antenatal depression in pregnant Korean females: the effect of bipolarity on depressive symptoms

Background This cross-sectional study sought to identify factors associated with antenatal depression in pregnant Korean females, including sociodemographic parameters, social support, social conflict, and bipolarity. Methods Eighty-four pregnant women were recruited to complete questionnaires on sociodemographic factors, obstetric history, depressive symptoms, and bipolarity. Depressive symptoms were assessed using the Korean version of the Edinburgh Postnatal Depression Scale. Bipolarity was assessed using the Korean version of the Mood Disorder Questionnaire. Results Nineteen participants (22.6%) had positive Mood Disorder Questionnaire scores, suggesting the presence of bipolarity, and were significantly more likely to score high on the Edinburgh Postnatal Depression Scale. Antenatal depression was associated with bad marital communication and marital dissatisfaction. Conclusion These results suggest that spousal interactions play a significant role in antenatal depression, and pregnant women with bipolarity may be more depressed than those without bipolarity.

Prevalence and correlates of bipolar spectrum disorder comorbid with ADHD features in nonclinical young adults

BACKGROUND We investigate the rate of bipolar spectrum disorder comorbid with ADHD features using two screening instruments, the Mood Disorder Questionnaire (MDQ) and the Wender Utah Rating Scale (WURS), in a nonclinical young adult population. METHODS College and graduate students aged 18 years or older from four universities in Korea were selected. Comorbidity was defined as both MDQ positivity and WURS positivity. To look for a trend in clinical characteristics according to the severity of the comorbid condition, we used the Jonckheere-Terpstra test and the linear-by-linear association test. We performed ordinal logistic regression analysis to identify predictors associated with the studied comorbid condition. RESULTS A total of 1948 subjects were included in the study, and 15 (0.8%) of them were found to have the comorbid condition defined as both MDQ positivity and WURS positivity. As the severity of the comorbid condition increased, we saw trends of lower socioeconomic status, higher history of suicidality, higher history of self-mutilating behavior, higher history of parental abuse or abuse by other people, more severe depression, and more severe problematic alcohol use. The ordinal regression analysis showed that history of parental abuse, depression, and problematic alcohol use predicted the comorbid condition. LIMITATIONS We did not use standardized diagnostic tools for case findings. CONCLUSION The condition of comorbid bipolar spectrum disorder with ADHD features had a notable prevalence of 0.8% in a nonclinical young adult sample. This comorbid condition was found to be related with serious clinical phenomenology.

Dose Trends of Aripiprazole from 2004 to 2014 in Psychiatric Inpatients in Korea

Objective Although aripiprazole has been widely used to treat various psychiatric disorders, little is known about the adequate dosage for Asian patients in clinical practice. Hence, we evaluated the initial and maximum doses of aripiprazole from 2004 to 2014 to estimate the appropriate dosage for Korean psychiatric inpatients in clinical practice. Methods In this retrospective study, we reviewed the medical records of patients who were hospitalized in five university hospitals in Korea from March 2004 to December 2014. The psychiatric diagnosis according to the text revision of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition during index hospitalization and the initial and maximum doses of aripiprazole were evaluated. Results There were 74 patients in Wave 1 (2004–2006), 201 patients in Wave 2 (2007–2010), and 353 patients in Wave 3 (2011–2014). The initial doses of aripiprazole in all diagnostic groups were significantly lower in Wave 3 than in Wave 2. The maximum doses of aripiprazole in each diagnostic group were not significantly different among Waves 1, 2, and 3. Conclusion The relatively low initial doses of aripiprazole documented in our study may reflect a strategy by clinicians to minimize the side effects associated with aripiprazole use, such as akathisia.

Lifetime suicidal attempts and current suicidal risk in aging survivors of the Jeju April 3 incident

BACKGROUND The Jeju April 3 incident refer to a series of armed uprisings and counterinsurgency that occurred between 1948 and 1954 on Jeju Island, South Korea. These events resulted not only in an estimated 15,000-30,000 deaths but also in numerous casualties and the destruction of many villages on the island. We investigated the relationship between lifetime suicidal attempts, current suicidal risk, and exposure to the traumatic experiences associated with the Jeju April 3 incident. METHODS The present study assessed the lifetime suicidal behaviors of 110 aging survivors of the Jeju April 3 incident and 492 community-dwelling older adults who had not personally experienced this incident. Participants completed a questionnaire gathering demographic information and the Mini International Neuropsychiatric Interview (M.I.N.I.) items on suicidal ideation, suicide plans, and suicide attempts. To obtain information regarding depressive symptoms, we administered the Center for Epidemiologic Studies-Depression Scale (CES-D). RESULTS The prevalence rate for suicidal ideation within the past month in survivors was 42.7%, 95%CI [33.88, 52.07], and that in the comparison group was 15.4%, 95%CI [12.53, 18.91]. The survivor group reported higher rates of lifetime suicide attempts (8.2%, 95%CI [4.36, 14.82]) than the comparison group (2.0%, 95%CI [1.11, 3.70]). LIMITATIONS The cross-sectional nature of the study design limits the interpretation of results. CONCLUSION These findings suggest that the psychological consequences of the Jeju April 3 incident, which occurred almost 70 years ago, may be long lasting. Our data can also contribute to interventions designed to prevent the development of serious psychological sequelae following traumatic events.