Psychometric evaluation of the Korean version of the Suicidal Ideation Scale in mentally ill patients living in the community.

OBJECTIVE: The purpose of this study was to translate the Suicidal Ideation Scale (SIS) into Korean (SIS-K) and then evaluate its psychometric properties in mentally ill Korean patients living in the community. METHODS: The SIS-K was translated into Korean using a translation and back-translation technique. A sample of 396 patients with mental disorders was recruited from regional mental health centres in Korea. Factorial-construct validity was tested using both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The data were randomly split into two subsamples: one used for EFA to identify the underlying structure of the items, and the other used for CFA to test whether the underlying structure was supported by actual data. Convergent validity, known-groups validity and internal-consistency reliability were tested. RESULTS: Exploratory factor analysis extracted nine items clustered into two subscales that accounted for 68.59% of the variance. One item ('I feel there is no solution to my problems other than taking my own life') was deleted. The structure of the two subscales was supported by CFA. The SIS-K score was moderately correlated with depression, and the scale demonstrated convergent validity. The SIS-K scores were significantly higher in patients who had attempted suicide, implying the presence of satisfactory known-groups validity. Cronbach's alpha of the total SIS-K was 0.91. CONCLUSIONS: The study has demonstrated the excellent psychometric properties of the SIS-K. The SIS-K is brief and easy to complete, and so it can be applied in both practice and research to patients with mental disorders. This cultural validation of the SIS-K will promote both domestic and international studies of suicidal ideation.

Determinants of length of stay for psychiatric inpatients: analysis of a national database covering the entire Korean elderly population.

OBJECTIVE: In a rapidly aging society, inappropriately long geropsychiatric inpatient hospitalization is a challenging concern for mental health policy-makers and researchers. This study aimed to investigate patient and institutional factors affecting geropsychiatric inpatient length of stay (LOS), providing an overview of current geropsychiatric health care system in South Korea. METHODS: This retrospective, population-based, cross-sectional study analysed nationwide reimbursement claim databases covering the entire elderly population of Korea between January 2005 and June 2006. Given the nested structure of the data, a multivariate multilevel regression analysis was performed. RESULTS: The average LOS was 128 days. Males, patients with schizophrenia, and those enrolled in a National Medical Care Aid program tended to have longer hospital stays. Patient age was negatively related to LOS. Institutional variables related to longer hospitalizations included a psychiatric hospital, a higher number of beds, fewer human resource employees, a higher proportion of male, oldest old, and patients with dementia. CONCLUSIONS: Our results suggest that policies targeting geropsychiatric patients diagnosed with schizophrenia, enrolled in National Medical Care Aid programs, and admitted to psychiatric hospitals could reduce LOS. Additionally, the impact of the patient composition of a medical institution on LOS needs to be closely investigated.

Partial versus full PTSD in the Korean community: prevalence, duration, correlates, comorbidity, and dysfunctions.

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.

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.

Comorbid mental disorders among the patients with alcohol abuse and dependence in Korea.

This study investigated the patterns of alcohol disorder comorbidity with other psychiatric disorders, using Korean nationwide epidemiological data. By two-stage cluster sampling, 5,176 adult household residents of Korea were interviewed using the Korean version of the Diagnostic Interview Schedule. Psychiatric disorders strongly associated with alcohol disorders were, other drug abuse or dependence, major depression, simple phobia, antisocial personality disorder, tobacco dependence, and pathological gambling. Male alcoholics had a tendency to begin with tobacco dependence, and some male pathological gamblers first had alcohol disorders. The presence of comorbid psychiatric disorders was associated with a more severe form and the later onset of alcohol disorders, and associated with help-seeking for alcohol abuse/dependence.