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BACKGROUND: Computerized cognitive training (CCT) has been proposed as a potential therapy for cognitive decline. One of the benefits of CCT is a transfer effect, but its mechanism on the memory domain is unclear. This study aimed to investigate the transfer effect of non-memory multidomain CCT on the memory domain and its neural basis in patients with mild cognitive impairment (MCI) through a randomized controlled trial. METHODS: Patients with MCI recruited from memory clinics were randomly assigned to either the CCT or the control group. The CCT group received multidomain CCT training excluding memory training, while the control group read educational books with learning-based quizzes twice a week for 8 weeks. Participants underwent memory tests yielding a composite score, other cognitive domain tests, non-cognitive scales, and resting-state functional magnetic resonance imaging (rsfMRI), at baseline and after intervention. Within- and between-group comparisons, group × time interactions, and seed-to-voxel analyses in memory-involving brain networks were performed. RESULTS: The CCT group showed improvement over the control group in memory domain (Group × time, F = 5.87, P = 0.03, η2 = 0.31), which was related with the increased connectivity in the hippocampal-frontal and fusiform-occipital network. No other cognitive and non-cognitive symptoms differed between groups after adjusting for covariates. CONCLUSION: Eight weeks of multidomain CCT without memory training improved memory function and restored functional network in the hippocampal and medial temporal region in MCI patients. These results can provide evidence for the transferring ability of CCT on memory functioning with its neural basis.
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Disfunción Cognitiva , Imagen por Resonancia Magnética , Memoria , Humanos , Disfunción Cognitiva/terapia , Disfunción Cognitiva/psicología , Masculino , Femenino , Anciano , Memoria/fisiología , Transferencia de Experiencia en Psicología/fisiología , Pruebas Neuropsicológicas/estadística & datos numéricos , Terapia Cognitivo-Conductual/métodos , Terapia Asistida por Computador/métodos , Resultado del Tratamiento , Persona de Mediana Edad , Encéfalo/diagnóstico por imagen , Encéfalo/fisiopatología , Entrenamiento CognitivoRESUMEN
OBJECTIVE: This study aimed to investigate the existence of a difference in quality of life (QOL) between individuals with and without significant subjective-objective discrepancy (SOD) in total sleep time (TST). METHODS: From the Sleep Heart Health Study 2, 2540 individuals who had completed polysomnography, a morning sleep survey, and the 36-item Short-Form Health Survey (SF-36) were included in the analyses. The participants were classified as normoestimators (estimation of TST <±60 minutes), underestimators (underestimation of TST ≥60 minutes), or overestimators (overestimation of TST ≥60 minutes). The standardized SF-36 QOL scores were compared among the three groups. An adjusted partial correlation analysis was conducted between SOD and QOL. RESULTS: Of the 2540 participants, 1617 (63.7%), 433 (17.0%), and 490 (19.3%) were assigned to the normoestimator, underestimator, and overestimator groups, respectively. The bodily pain and social functioning components of the SF-36 score were significantly lower in the underestimators than in the normoestimators, whereas the physical functioning component was significantly lower in the overestimators than in the normoestimators. The absolute value of SOD in the TST showed a significant negative correlation with the physical and mental components of the SF-36. CONCLUSIONS: QOL was significantly better in the normoestimator than in the other groups and linearly correlated with the absolute value of SOD. This study suggests that a high prevalence of positive and negative sleep misperception in a community population can be a potential factor associated with poor QOL and potential comorbidities.
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Calidad de Vida , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Polisomnografía , Sueño , Superóxido DismutasaRESUMEN
BACKGROUND: Insomnia is a common disorder that affects a vast number of patients; the hyperarousal theory of insomnia postulates that patients with insomnia are physiologically activated not only at nighttime but also during the daytime. We aimed to investigate the differences in the resting-state functional connectivity (RSFC) of the thalamus with cortical areas between patients with insomnia disorder and healthy controls. METHODS: All participants completed clinical questionnaires and underwent portable polysomnography and resting-state fMRI. RESULTS: Patients in the insomnia group (n = 50) showed increased RSFC between the thalamus and right medial superior frontal area, bilateral middle temporal areas, left rectus and right parahippocampal areas compared with controls (n = 42) after controlling for age, sex and education level. Among the pairs that showed increased connectivity, several functional connections were negatively correlated with sleep efficiency, measured by polysomnography.Limitations: We used a small sample size. CONCLUSION: We consider these results on increased thalamocortical hyperactivity in brain areas related to sensory functions as providing evidence for the hyperarousal theory of insomnia.
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Imagen por Resonancia Magnética , Trastornos del Inicio y del Mantenimiento del Sueño , Encéfalo/diagnóstico por imagen , Mapeo Encefálico , Humanos , Imagen por Resonancia Magnética/métodos , Polisomnografía , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico por imagen , Tálamo/diagnóstico por imagenRESUMEN
BACKGROUND: Cognitive reserve (CR) is a concept proposed to account for discrepancies between the extent of brain pathology and clinical manifestations of that pathology. This study aimed to explore the associations between CR and the effects of cognitive training using fully immersive virtual reality (VR). METHODS: A total of 44 older adults (22 cognitively normal, 22 with mild cognitive impairment) underwent eight cognitive training sessions using VR for a period of 4 weeks. CR was assessed using the Cognitive Reserve Index questionnaire (CRIq). To evaluate baseline cognitive function and the effects of VR training, the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery was administered to all participants before and after the training. RESULTS: Greater improvement in the total CERAD score was seen for cognitively normal participants with higher versus lower scores on the Education subdomain of the CRIq. Among patients with mild cognitive impairment, none of the CRIq subdomain scores (Education, Working Activity, Leisure Time) were related to a change in CERAD total scores. The CRIq total score did not predict the improvement of global cognition in either group. CONCLUSIONS: This study revealed different impacts of CR on cognitive training according to the participants' cognitive status. It also suggests that employing three proxies of CR rather than using a composite score would provide a more accurate understanding of one's CR.
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Disfunción Cognitiva , Reserva Cognitiva , Realidad Virtual , Anciano , Cognición , Humanos , Pruebas NeuropsicológicasRESUMEN
BACKGROUND: Early detection of oppositional defiant behavior is warranted for timely intervention in children at risk. This study aimed to build a predictive model of persistent oppositional defiant behavior based on a machine learning algorithm. METHODS: With nationwide cohort data collected from 2012 to 2017, a tree-based ensemble model, random forest, was exploited to build a predictive model for persistent oppositional defiant behavior. The persistent oppositional defiant behavior was defined by the presence of oppositional defiant behavior for all the five years. The area under the receiver operating characteristic curve (AUC), overall accuracy, sensitivity, specificity, and Matthew's correlation coefficients (MCC) were measured. RESULTS: Data of 1,323 children were used for building the machine learning-based predictive model. The baseline mean ± standard deviation month-age of the participants was 51.0 ± 1.2 months. The proportion of persistent oppositional defiant behavior was 0.98% (13/1323). In the hold-out test set, the overall accuracy, AUC, sensitivity, specificity, and MCC were 0.955, 0.982, 1.000, 0.954, and 0.417, respectively. CONCLUSION: Our study demonstrated that the machine learning-based approach is useful for predicting persistent oppositional defiant behavior in preschool-aged children.
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Déficit de la Atención y Trastornos de Conducta Disruptiva , Aprendizaje Automático , Déficit de la Atención y Trastornos de Conducta Disruptiva/diagnóstico , Déficit de la Atención y Trastornos de Conducta Disruptiva/epidemiología , Niño , Preescolar , Estudios de Cohortes , Humanos , Sensibilidad y EspecificidadRESUMEN
The acute treatment duration for major depressive disorder (MDD) is 8 weeks or more. Treatment of patients with MDD without predictors of treatment response and future recurrence presents challenges and clinical problems to patients and physicians. Recently, many neuroimaging studies have been published on biomarkers for treatment response and recurrence of MDD using various methods such as brain volumetric magnetic resonance imaging (MRI), functional MRI (resting-state and affective tasks), diffusion tensor imaging, magnetic resonance spectroscopy, near-infrared spectroscopy, and molecular imaging (i.e., positron emission tomography and single photon emission computed tomography). The results have been inconsistent, and we hypothesize that this could be due to small sample size; different study design, including eligibility criteria; and differences in the imaging and analysis techniques. In the future, we suggest a more sophisticated research design, larger sample size, and a more comprehensive integration including genetics to establish biomarkers for the prediction of treatment response and recurrence of MDD.
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Biomarcadores/metabolismo , Trastorno Depresivo Mayor/diagnóstico por imagen , Trastorno Depresivo Mayor/terapia , Neuroimagen , Trastorno Depresivo Mayor/genética , Humanos , Aprendizaje Automático , RecurrenciaRESUMEN
Because suicide is irreversible, prevention is paramount. For the optimal strategy to reduce lethal means, we sought to investigate age- and sex-associated variations in suicide methods. Data on annual causes of death from 1991 to 2015 in the Republic of Korea were used. Major sociodemographic correlates of the five suicide methods were analyzed by multiple multinominal logistic regression analysis. Among a total of 239,565 suicides from 1991 to 2015, hanging was most common. Gas poisoning sharply increased from 2007 to 2015. The gap between hanging and the second most common method of suicide has increased from 659 in 2004 to 4,433 in 2015. Charcoal burning was most commonly used by males younger than 45 years of age, whereas pesticide was commonly used by both sexes ages 55 years and older. Our results suggest that age- and sex-specific suicide prevention strategies are needed, particularly for gas and pesticide poisoning.
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Suicidio/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Escolaridad , Femenino , Humanos , Masculino , Estado Civil , Persona de Mediana Edad , República de Corea/epidemiología , Factores Sexuales , Adulto JovenRESUMEN
BACKGROUND: Magnesium (Mg2+), an endogenous N-methyl-D-aspartate receptor antagonist, has received increased attention recently because of its role in the pathophysiology of and treatment response in depression. However, whether Mg2+ level is decreased in depression is not firmly established. We aimed to conduct a systematic review and meta-analysis to help making consensus for the association between Mg2+ levels and depression. METHODS: A systematic search was conducted in the electronic database resources PubMed and Embase. After a careful selection of relevant studies, a meta-analysis using the random effects model was conducted in each measuring source, such as serum, plasma, and cerebrospinal fluid (CSF). RESULTS: A total of 18 studies were included in this study. Among 11 studies that measured Mg2+ in the serum, Mg2+ level was lower in patients with depression than in controls (weighted mean difference = -.088, 95% confidence interval = -.164 to -.012). In the sensitivity analysis by removing studies one by one, 2 out of the 11 studies obliterated such significant differences. There were no significant differences in the Mg2+ levels in the studies for plasma and CSF. CONCLUSIONS: Despite some evidence supporting an association between decreased Mg2+ levels and depression from studies with serum, the results of our meta-analysis urge to use caution when associating Mg2+ levels and depression. Future studies are needed to establish a consensus for the role of low Mg2+ levels in depression.
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Depresión/sangre , Depresión/diagnóstico , Magnesio/sangre , Biomarcadores/sangre , Depresión/psicología , Humanos , AutoimagenRESUMEN
OBJECTIVE: Continuous positive airway pressure (CPAP) is the preferred treatment for obstructive sleep apnea (OSA). However, compliance with CPAP therapy varies among studies, and studies on its predictors are insufficient in Korea. This study aimed to identify factors that predict compliance with CPAP therapy in patients with OSA. METHODS: We retrospectively reviewed medical records, polysomnography (PSG) records, and self-report questionnaires of patients w ith OSA. Criteria for compliance was the use of CPAP devices for ≥4 h per night for ≥70% of the consecutive 30 nights (i.e., 21 days) during the first 3 months of treatment initiation. The patients were classified into two groups: compliant and non-compliant. Logistic regression analyses were performed to identify the clinical factors and PSG parameters associated with CPAP compliance. RESULTS: Of the 188 participants, 80 were classified into the compliant group and 108 into the non-compliant group. The ratios of stage N1 (p=0.011) and health insurance coverage (p=0.007) were significantly associated with compliance with CPAP, with an explanatory power of 18.6% (R2=0.186, p<0.001). CONCLUSION: Stage N1 ratio and health insurance coverage were significant predictors of CPAP compliance. It is necessary to confirm whether the relationship between a high stage N1 ratio and compliance can be reproduced in a larger sample and in individuals from other countries.
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OBJECTIVE: Schizophrenia-spectrum disorders and posttraumatic stress disorder (PTSD) share common clinical manifestations, genetic vulnerability, and environmental risk factors. We aimed to conduct a systematic review and meta-analysis of the comorbid prevalence of PTSD among schizophrenia-spectrum disorders. METHODS: We performed a meta-analysis to identify possible contributing factors to the heterogeneity among these studies. We systematically searched electronic databases with no restrictions on language of articles. RESULTS: We extracted 24 samples (18 for current prevalence and 6 for lifetime prevalence) from 22 studies and used a random effects model to estimate the pooled prevalence of PTSD among schizophrenia-spectrum disorders. The current and life prevalence of comorbid PTSD was 10.6% (95% confidence interval [CI]=6.3%-17.3%) and 13.0% (95% CI=5.3%-28.6%), respectively. Studies assessing psychotic experiences/involuntary admission reported the highest prevalence of comorbid PTSD (57.1%, 95% CI=43.6%-59.7%), whereas those assessing various anxiety disorders reported the lowest prevalence (1.1%, 95% CI=1.0%-5.5%). Heterogeneities of the subgroup analysis by similar objectives were largely homogeneous (I2=7.1-34.1). In the qualitative assessment, only two studies (9.1%) were evaluated as having a low risk of bias. CONCLUSION: Our results showed that a careful approach with particular attention to assessing PTSD is essential to reliably estimate the prevalence of PTSD comorbid with schizophrenia-spectrum disorders. The reason for the wide discrepancy in the prevalence of comorbid PTSD among the four groups of studies should be addressed in future research.
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Introduction: Abnormalities in myelin are believed to be one of the important causes of major depressive disorder, and it is becoming important to more accurately quantify myelin in in vivo magnetic resonance imaging of major depressive disorder patients. We aimed to investigate the difference in myelin concentration in the white matter and subcortical areas using new quantitative myelin-related maps of high-resolution 7 Tesla (7 T) magnetic resonance imaging between patients with major depressive disorder and healthy controls. Methods: Myelin-related comparisons of the white matter and nearby subcortical regions were conducted between healthy controls (n = 36) and patients with major depressive disorder (n = 34). Smoothed quantitative ratio (sq-Ratio) myelin-related maps were created using the multi-echo magnetization-prepared two rapid gradient echoes (ME-MP2RAGE) sequence of the T1 and T2* images of 7 T magnetic resonance imaging. Differences in the myelin-related values of the regions of interest between the two groups were analyzed using a two-sample t-test, and multiple comparison corrections were performed using the false discovery rate. Results: The average sq-Ratio myelin-related values were 2.62% higher in the white matter and 2.26% higher in the subcortical regions of the healthy controls group than in the major depressive disorder group. In the group analysis of the healthy control and major depressive disorder groups, the sq-Ratio myelin-related values were significantly different in the fornix area of the white matter (false discovery rate-corrected p = 0.012). In addition, significant differences were observed in both the left (false discovery rate-corrected p = 0.04) and right thalamus (false discovery rate-corrected p = 0.040) among the subcortical regions. Discussion: The average sq-ratio myelin-related value and sq-ratio myelin-related values in the fornix of the white matter and both thalami were higher in the healthy controls group than in the major depressive disorder group. We look forward to replicating our findings in other populations using larger sample sizes.
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BACKGROUND: The association between air pollutants and psychiatric disorders has been investigated in many countries. However, results for the association between air pollutants and emergency room (ER) visits for psychiatric disorders are inconsistent. Further, systematic large-scale studies relating to the same are lacking, especially in South Korea. OBJECTIVE: We aimed to investigate the acute and short-term cumulative effect of air pollutants on ER visits for psychiatric disorders in South Korea. METHODS: The data on nitrogen dioxide (NO2) and particulate matter (PM2.5 and PM10) and ER visits due to nine representative psychiatric disorders were collected from eight major cities in South Korea for three years. We estimated the relative risk (RR) at lag 0 and a cumulative 11-day RR by increasing a 10-unit for PM and 0.01-unit for NO2 using the Distributed Lag Nonlinear Model. RESULTS: During the study period, a total of 79,092 ER visits for psychiatric disorders were identified and tested for association with NO2, PM2.5, and PM10. The RR at lag 0 of depression per 0.01-unit increase in NO2 was the highest (3.127; 95% confidence interval [CI] 2.933 to 3.332) among the psychiatric disorders. The RRs at lag 0 of anxiety disorders per 10-unit increase in PM2.5 (1.709; 95% CI 1.424 to 2.053) and PM10 (2.168; 95% CI 1.957 to 2.403) were the highest among the psychiatric disorders. SIGNIFICANCE: Air pollutants increased ER visits for psychiatric disorders with the highest RR of depression due to NO2 and anxiety disorder due to PM2.5 and PM10. These results contribute evidence to the positive association between ambient exposure to air pollution and aggravation of psychiatric disorders, indicating air pollution may be a modifiable risk factor in mental health management. IMPACT STATEMENT: We investigated the effect of air pollution on emergency room visits caused by major psychiatric disorders in prominent cities in South Korea. Using the Distributed Lag Nonlinear Model, an advanced analysis method, we calculated the acute effect and short-term cumulative effect. Air pollutants increased ER visits for psychiatric disorders with the highest relative risk of depression due to NO2 and anxiety disorder due to PM2.5 and PM10. These results reveal an association between ambient exposure to air pollution and aggravation of psychiatric disorders and suggest that air pollution may be a modifiable risk factor in mental health management.
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Contaminantes Atmosféricos , Contaminación del Aire , Trastornos Mentales , Humanos , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Dióxido de Nitrógeno/efectos adversos , Dióxido de Nitrógeno/análisis , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Material Particulado/efectos adversos , Material Particulado/análisis , Trastornos Mentales/epidemiología , Trastornos Mentales/inducido químicamente , República de Corea/epidemiología , Servicio de Urgencia en Hospital , ChinaRESUMEN
PURPOSE: Suicide is an important health and social concern worldwide. Both suicidal ideation and suicide rates are higher in the elderly population than in other age groups; thus, more careful attention and targeted interventions are required. Therefore, we have developed a model to predict suicidal ideation in the community-dwelling elderly aged of >55 years. PATIENTS AND METHODS: A random forest algorithm was applied to those who participated in the Korea Welfare Panel. We used a total of 26 variables as potential predictors. To resolve the imbalance in the dataset resulting from the low frequency of suicidal ideation, training was performed by applying the synthetic minority oversampling technique. The performance index was calculated by applying the predictive model to the test set, which was not included in the training process. RESULTS: A total of 6410 elderly Korean aged of >55 (mean, 71.48; standard deviation, 9.56) years were included in the analysis, of which 2.7% had suicidal ideation. The results for predicting suicidal ideation using the 26 chosen variables showed an AUC of 0.879, accuracy of 0.871, sensitivity of 0.750, and specificity of 0.874. The most significant variable in the predictive model was the severity of depression, followed by life satisfaction and self-esteem factors. Basic demographic variables such as age and gender demonstrated a relatively small effect. CONCLUSION: Machine learning can be used to create algorithms for predicting suicidal ideation in community-dwelling elderly. However, there are limitations to predicting future suicidal ideation. A predictive model that includes both biological and cognitive indicators should be created in the future.
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Background: There still are limitations associated with quantifying myelin content using brain magnetic resonance imaging (MRI) despite several studies conducted on this subject. Therefore, this study aimed: (1) to propose a myelin-related mapping technique to obtain the quantitative R1/T2* (q-Ratio) that has the advantage of quick processing and less dependency on imaging parameters, (2) to validate this adapted q-Ratio method by comparing the quantitative myelin-related map with those acquired through an existing mapping method [T1-weighted/T2*-weighted (w-Ratio)], and (3) to determine the q-Ratio myelin-related values in the white and gray matter, and the relationship between the q-Ratio myelin-related value and cerebral volume size in regions of interest (ROIs) in a healthy population. Methods: The multi-echo magnetization-prepared 2 rapid gradient echoes (ME-MP2RAGE) sequence was used in a 7 Tesla (7T) MRI for the acquisition of data regarding myelin content in 10 healthy participants. A correlation analysis was performed between myelin-related values obtained through the q-Ratio and w-Ratio methods. Additionally, myelin distribution was analyzed and compared in the white and gray matter, and the correlation between cerebral volume size and q-Ratio myelin-related value was analyzed in ROIs in the brain. Results: The myelin-related maps acquired through the q-Ratio and w-Ratio methods were significantly correlated (p < 0.001), but the q-Ratio myelin-related map was much clearer. Additionally, the cerebral volume size in the gray matter was 399.40% larger than that in the white matter, but the q-Ratio myelin-related value in the gray matter was 80.83% lower than that of the white matter. Furthermore, volume size was positively correlated with q-Ratio myelin-related values in the white matter (r = 0.509, p = 0.006) but not in the gray matter (r = -0.133, p = 0.402). Conclusions: In this study, we validated using a q-Ratio myelin-related map that was acquired in one imaging sequence at 7T MRI. In addition, we found a significant correlation between ROI volume size and the q-Ratio myelin-related value in the white matter but not in the gray matter. It is expected that this technique could be applied to the study of various neuropsychiatric diseases related to demyelination in the future.
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Background: In animal experiments, the habenula and septal nuclei are known as the key brain areas of depression. However, there are few magnetic resonance imaging (MRI) studies on the functional connectivity between these areas and the subcortical areas in humans with major depression. We aimed to investigate the difference in resting-state functional connectivity (RSFC) among the major regions of interest (ROI) in the subcortical areas, including both the habenula and septal nuclei. Methods: We performed the seed-to-voxel analysis to investigate the RSFC between both the habenula and septal nucleus, as well as other subcortical regions. Furthermore, ROI-to-ROI analysis was performed among the combinations of ROI pairs in the subcortical areas. Results: The seed-to-voxel analysis showed a lower RSFC between the left habenula and the cerebellum in major depressive disorder (MDD) than in healthy controls (HCs). As a result of ROI-to-ROI analysis in subcortical areas, a total of 31 pairs of FCs in the MDD group showed a lower RSFC than in the HCs group. Conclusion: This study revealed a lower RSFC between the left habenula and cerebellum in patients with MDD and reduced RSFC among numerous subcortical areas. These new findings on the neural circuitry of MDD might contribute to an in-depth understanding of depression.
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Objective: This study aimed to compare the mean pulse rate (PR) and mean blood pressure (BP) between patients with obstructive sleep apnea (OSA) and those with simple snoring (SS) during a 24-hour period, and to investigate the correlation between apnea-hypopnea index (AHI), PR, and BP in sleep-related breathing disorder (SRBD) patients with and without hypertension, diabetes mellitus (DM), and cardiovascular diseases (CVDs). Methods: Ninety SRBD patients underwent full-night polysomnography, and ambulatory BP and PR were monitored for 24 hours. Participants were classified into OSA (AHI ≥ 5) and control (SS) (AHI < 5) groups, and BP and PR were compared. Participants were also divided into groups with and without hypertension, CVDs, or DM to analyze the correlation between AHI, BP, and PR in each group. Results: Mean PRs during the daytime period and during the whole 24-hour period in the OSA group were significantly higher than those in the SS group after controlling for potential confounders. No significant difference was observed in mean BP between the groups. Partial correlation analysis after controlling for confounders showed significant correlation between AHI and PR during daytime and the 24-hour period in participants without hypertension, DM, or CVDs, but not in participants with these conditions. Conclusion: The significant differences and correlations only in PR (not in BP) found in this study suggest that PR could be an early marker for SRBD in individuals without comorbidities, and that an increased sympathetic tone could be responsible for future occurrence of CVD.
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Previous spectral analysis studies on insomnia have shown inconsistent results due to their heterogeneity and small sample sizes. We compared the difference of electroencephalogram (EEG) spectral power during sleep among participants without insomnia, insomniacs with no hypnotic use, hypnotic users with no insomnia complaints, and hypnotic users with insomnia complaints using the Sleep Heart Health Study data, which is large sample size and has good quality control. The fast Fourier transformation was used to calculate the EEG power spectrum for total sleep duration within contiguous 30-s epochs of sleep. For 1985 participants, EEG spectral power was compared among the groups while adjusting for potential confounding factors that could affect sleep EEG. The power spectra during total sleep differed significantly among the groups in all frequency bands (pcorr < 0.001). We found that quantitative EEG spectral power in the beta and sigma bands of total sleep differed (pcorr < 0.001) between participants without insomnia and hypnotic users with insomnia complaints after controlling for potential confounders. The higher beta and sigma power were found in the hypnotic users with insomnia complaints than in the non-insomnia participants. This study suggests differences in the microstructures of polysomnography-derived sleep EEG between the two groups.
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Ondas Encefálicas/efectos de los fármacos , Polisomnografía , Fármacos Inductores del Sueño/uso terapéutico , Trastornos del Inicio y del Mantenimiento del Sueño/tratamiento farmacológico , Sueño REM/efectos de los fármacos , Adulto , Anciano , Estudios de Casos y Controles , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fármacos Inductores del Sueño/farmacologíaRESUMEN
In South Korea, the suicide rate is more than double the OECD average, and precise identification of the cause is required for suicide prevention. Psychological autopsy is used to reveal factors related to suicidal behavior; however, such studies are lacking in Korea. This study investigated the factors related to suicide using psychological autopsies in Incheon, a major city in Korea. In total, 46 cases were investigated using the Korea-Psychological Autopsy Checklist (K-PAC), and data on mental health conditions and psychosocial factors of suicide decedents and their families were analyzed. It was estimated that 87% of individuals of suicides had a mental health condition before death, but only 15.2% continued treatment or counseling. Most individuals who died of suicide showed warning signs before death, but only 19.6% of survivors of suicide loss noticed them. Mental health concerns before and after the death of the individual were also identified in more than half of their families. To prevent suicide, intensive and continuous treatment for psychiatric conditions and prompt recognition of active response to suicide warning signs are required. Care for the mental health of family members is also important.
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Suicidio , Autopsia , Humanos , República de Corea/epidemiología , Factores de Riesgo , Ideación Suicida , Suicidio/psicología , SobrevivientesRESUMEN
Purpose: Antarctica is a region with extreme climate, characterized by extreme cold and photoperiod. No research has been conducted on the mental health of Korean Antarctic dispatchers. The aim of this study was to investigate the status of mental illness and changes in mood and sleep among Korean crew members staying for a long-term period in the Antarctic station. Methods: From 2017 to 2020, crew members who were dispatched from South Korea to two Antarctic stations for a one-year period participated in this study. The crew were evaluated for mood and sleep status and mental illness through psychological tests and interviews by board-certified psychiatrists once before departure and twice during their stay in Antarctica. The incidence of mental illness was confirmed and changes in sleep and depression were analyzed. Results: A total of 88 participants were included in the final analysis, and 7 of them (8.0%) were diagnosed with mental disorders such as insomnia in early winter. The total Beck Depression Inventory (BDI) score increased significantly in the early winter period, and the total Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Inventory (PSQI) scores increased in both early and late winter. The difference in changes in mood and sleep symptoms before, during, and after dispatch between the two stations was not significant. Conclusion: This is the first study to investigate the mental illness and mood and sleep status of Korean crews dispatched to Antarctica. In early winter, there were significant increases in mental illness and depressive symptoms, and a worsening of sleep status.