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Objective@#We aimed to explore whether nursing professionals’ psychological states affect their grief response for a patient’s death in the coronavirus disease-2019 (COVID-19) inpatients’ ward. @*Methods@#Survey was conducted among frontline nursing professionals working in COVID-19 inpatients wards at three tertiary-level affiliated hospitals of the University of Ulsan during April 7–26, 2022. Participants’ information such as age, years of employment, or marital status were collected, and their responses to rating scales including Pandemic Grief Scale (PGS) for healthcare workers, Stress and Anxiety to Viral Epidemics-9 items (SAVE-9), Patient Health Questionnaire-9 (PHQ-9), Loneliness and Social Isolation Scale, and Insomnia Severity Scale (ISI) were collected. @*Results@#All 251 responses were analyzed. We observed that 34% reportedly suffered from depression. The linear regression analysis showed that a high PGS score was expected by high SAVE-9 (β=0.12, p=0.040), high PHQ-9 (β=0.25, p<0.001), high loneliness (β=0.17, p=0.006), and high ISI score (β=0.16, p=0.006, F=20.05, p<0.001). The mediation analysis showed that the depression of nursing professionals directly influenced their pandemic grief reaction, and their work-related stress and viral anxiety, insomnia severity, and loneliness partially mediated the association. @*Conclusion@#We confirm that frontline nursing professionals’ depression directly influenced their grief reaction, and their work-related stress and viral anxiety, insomnia severity, and loneliness partially mediated the association. We hope to establish a psychological and social support system for the mental health of nurses working in the COVID-19 wards.
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Objective@#The relationship between benzodiazepine use and cognitive decline in insomnia patients has been reported, but still conflicting. Thus, we tried to determine whether long-term exposure of benzodiazepine might be associated with changes of cognition and electroencephalography (EEG) findings in patients with chronic insomnia. @*Methods@#Insomniacs using benzodiazepines (n=29), drug-free insomniacs (n=27), and age- and sex-matched controls (n=28) were recruited. Neurocognitive function tested with Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet Neuropsychological Assessment Battery, quantitative EEG in awake state, and information of benzodiazepine usage were obtained. @*Results@#Drug-free insomniacs reported more severe symptoms than insomniacs using benzodiazepine (p<0.001). Insomniacs using benzodiazepine showed a decrease of executive function in Trail Making Test A than drug-free insomniacs and controls (0.73±0.66 vs. 1.27±0.38 vs. 1.09±0.47, p<0.001) and in categorical fluency than drug-free insomniacs (-0.01±0.99 vs. 1.26±0.97, p=0.002). However, such decrease of executive function was not proportional to daily dose or cumulative dose of benzodiazepine. The EEG was not significantly different between insomniacs using benzodiazepine and drug-free insomniacs, while EEG of insomniacs showed low relative theta power in frontal and parietal regions but high relative beta power in frontal region than that of controls. @*Conclusion@#Benzodiazepine users with chronic insomnia showed an impairment of executive function compared to drug-free insomniacs and controls although they showed relatively decreased severity of insomnia symptoms. Chronic insomniacs showed a hyper-arousal manifestation in front-parietal region of brain regardless of benzodiazepine exposure.
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Objective@#We investigated which factors in psychological changes positively or negatively affect the quality of life to suggest desirable directions in the period of the COVID-19 pandemic. @*Methods@#Online survey was conducted with 1,011 adults more than 19 years old in Busan, South Korea. Quality of life was measured using the World Health Organization Quality of Life-BREF. Questions regarding the psychological changes were about COVID-19-related concerns, distress in complying with quarantine guidelines, and interest in seeking something to do alone. @*Results@#Quality of life was perceived to be below average (mean±SD, 2.86±0.53). The more economic worries there were, the lower the quality of life in psychological, social relationships and environmental domains. The more distress one experienced when maintaining their personal hygiene, the higher the quality of life related to their physical health. Likewise, the more difficult it was to maintain social distances, the higher the quality of life associated with psychological and social relationships. The more interested someone was in how to spend time alone, the higher the quality of life in all domains significantly. @*Conclusion@#We can minimize the negative impacts of COVID-19 by maintaining economic stability, maintaining prosocial behaviors related to personal hygiene and making good use of personal time.
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Objective@#We investigated which factors in psychological changes positively or negatively affect the quality of life to suggest desirable directions in the period of the COVID-19 pandemic. @*Methods@#Online survey was conducted with 1,011 adults more than 19 years old in Busan, South Korea. Quality of life was measured using the World Health Organization Quality of Life-BREF. Questions regarding the psychological changes were about COVID-19-related concerns, distress in complying with quarantine guidelines, and interest in seeking something to do alone. @*Results@#Quality of life was perceived to be below average (mean±SD, 2.86±0.53). The more economic worries there were, the lower the quality of life in psychological, social relationships and environmental domains. The more distress one experienced when maintaining their personal hygiene, the higher the quality of life related to their physical health. Likewise, the more difficult it was to maintain social distances, the higher the quality of life associated with psychological and social relationships. The more interested someone was in how to spend time alone, the higher the quality of life in all domains significantly. @*Conclusion@#We can minimize the negative impacts of COVID-19 by maintaining economic stability, maintaining prosocial behaviors related to personal hygiene and making good use of personal time.
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Objectives@#：The aim of this study was to determine how the efficacy and compliance of positive airway pressure (PAP) varies depending on the depressive symptom with obstructive sleep apnea (OSA). @*Methods@#：We collected data about baseline Apnea-Hyponea Index (AHI), sleep and mood state and demographic information from 125 obstructive sleep apnea patients prior to the start of positive airway pressure treatment. The Apnea-Hyponea Index and daytime sleepiness were examined as indicators of efficacy of positive airway pressure and daily average usage time and the utilization rate (%) for more than 4 hours were calculated as indicators of compliance of positive airway pressure at the time of 1, 3 or 9 months after the start of positive airway pressure. Repeated-measures ANOVA and linear mixed model (LMM) with adjusting age, body mass index and baseline Insomnia severity index were used for revealing any significant differences between groups over time passed. @*Results@#：This difference was confirmed at 9 months after starting positive airway pressure, between the two groups and the usage rate for more than 4 hours in depressive group was lower than that in non-depression group (56.2% vs. 67.5%). @*Conclusions@#：We demonstrated that there would be a difference in the compliance of positive airway pressure among patients with obstructive sleep apnea according to depressive state. Therefore, we suggest evaluating depressive symptoms in patients with obstructive sleep apnea before starting positive airway pressure, to increase the compliance of the positive airway pressure, which is essential to maintain the efficacy of the positive airway pressure.
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Objectives@#It remains unclear whether methylphenidate (MPH) has yadverse effects on growth in children. This study aimed to investigate the association of MPH with serum biological markers of growth in children with attention-deficit/hyperactivity disorder (ADHD). @*Methods@#The present study included 103 children with ADHD (64 drug-naive children, 39 MPH-treated children) and 112 control subjects. Children with ADHD were diagnosed on the basis of a semi-structured interview. Levels of biochemical markers of growth, including insulin-like growth factor-I, thyroid stimulating hormone (TSH), free T4, calcium, phosphorus, alkaline phosphatase, vitamin D, hemoglobin, total protein, albumin, total cholesterol, and hematocrit were measured in these individuals. @*Results@#Except in case of TSH, no intergroup differences were found in the levels of the growth markers. The levels of TSH were found to be lower in the MPH-treated boys with ADHD than in the drug-naive and control groups (p<0.05), although the levels of TSH in all the groups were within normal limits. @*Conclusion@#In this cross-sectional study, no significant association was found between MPH and growth markers. This calls for the need to carry out prospective longitudinal research studies in the future that investigate the effect of MPH on the growth trajectory in children.
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Objectives@#This study aims to compare attitude toward suicide among the elderly with suicide attempt, suicide ideation, and without suicide ideation and attempt. @*Methods@#We recruited study groups according to suicide risk. Suicide attempt/ideation group were recruited from Busan Regional Suicide Prevention Center. Control group was recruited from general population. Suicide attempt group was those who attempted suicide within 6 months prior to study participation. Suicide ideation group was those who had suicide ideation within 6 months prior to study participation but did not have lifetime history of suicide attempt. Control group was those who did not have either lifetime history of suicide ideation and attempt. Attitude toward suicide was evaluated by Korean version of Attitude Toward Suicide-20 (ATTS-20) Questionnaire. @*Results@#Total of 141 elderly people aged over 60 were recruited. Four subscale scores of ATTS-20 (permissiveness and nonintervention; preventability and incomprehensibility; universality; unpredictability) were significantly lower in the suicide attempt group than suicide ideation and control group. @*Conclusion@#The results of present study suggest that the elderly who had history of suicide attempt are more permissive toward and have lack of comprehension of suicide. These results can be useful to develop effective suicide intervention and prevention strategy for the elderly.
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OBJECTIVE: This study aims to investigate differences between the elderly living alone and those living with others in frustrated interpersonal needs and life satisfaction. Also, we explore the effects of frustrated interpersonal needs on life satisfaction in the elderly living alone. METHODS: The participants include 572 elderly people aged over 60 in Busan, Korea. Life satisfaction were evaluated by the Life Satisfaction Self-Rating Scale (LSRS) and frustrated interpersonal needs were measured by the Interpersonal Needs Questionnaire-Revised (INQ-R). RESULTS: The overall LSRS scores were significantly lower in the elderly living alone (106.2±20.1) than living with others (115.3±13.9, p<0.001). The total INQ-R score was significantly lower in the elderly living alone (73.8±12.1) than those living with others (76.9±12.0, p<0.05). As a result of multiple regression analysis, we came to know that frustrated interpersonal needs were factors affecting life satisfaction in living alone group. CONCLUSION: The results of present study suggest that the elderly living alone are more likely to have poor life satisfaction and frustrated interpersonal needs. Also, frustrated interpersonal needs are related to life satisfaction. Thus, it is necessary to establish the social support system such as social isolation prevention and interpersonal relationship development.
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Aged , Humans , Korea , Social IsolationABSTRACT
OBJECTIVE: The present study compared cancer-related fatigue (CRF) and chronic fatigue syndrome (CFS) using multidimensional measurements with the aim of better understanding characteristics and exploring markers of two similar fatigue syndromes. METHODS: Twenty-five patients with CRF and twenty patients with CFS completed questionnaires, including the Fatigue Severity Scale (FSS), Hospital Anxiety Depression Scale (HADS), Perceived Stress Scale (PSS), and Pittsburgh Sleep Quality Index (PSQI). Additionally, levels of high sensitivity C-reactive protein (hs-CRP), heart rate variability (HRV), and electroencephalography (EEG) were obtained. Neurocognitive functioning was also evaluated. RESULTS: Both groups showed comparable levels of psychological variables, including fatigue. Compared to CFS subjects, CRF patients had significantly higher hs-CRP levels and a reduced HRV-index. The within-group analyses revealed that the FSS score of the CRF group was significantly related to scores on the HADS-anxiety, HADS-depression, and PSQI scales. In the CFS group, FSS scores were significantly associated with scores on the PSS and the absolute delta, theta, and alpha powers in frontal EEG. CONCLUSION: Findings indicate that different pathophysiological mechanisms underlie CFS and CRF. Inflammatory marker and HRV may be potential biomarkers for distinguishing two fatigue syndromes and frontal EEG parameters may be quantitative biomarkers for CFS.
Subject(s)
Humans , Anxiety , Biomarkers , C-Reactive Protein , Depression , Electrocardiography , Electroencephalography , Fatigue Syndrome, Chronic , Fatigue , Heart Rate , Weights and MeasuresABSTRACT
OBJECTIVE: The aim of this study was to determine the clinical course of restless legs syndrome (RLS) and potential risk factors for the persistence of RLS symptoms after iron normalization in women with RLS and low serum ferritin (<50 μg/L). METHODS: We reviewed 39 women with RLS and iron deficiency, who achieved iron normalization after oral iron replacement for three months. Risk factors contributing to symptom persistence were estimated by logistic regression analyses. Remission was defined as no RLS symptoms for at least 6 months after the iron normalization. RESULTS: Over the observation period of 2.5±1.4 years, 15 patients reported no RLS symptom whereas 24 patients still complained of RLS symptoms. The remission rate of RLS with iron replacement was 38.5%. The relative risk of symptom persistence was increased by the duration of RLS symptoms (OR: 1.88, 95% CI: 1.01–3.49) or by the age at RLS diagnosis (OR: 1.25, 95% CI: 1.01–1.56). CONCLUSION: Almost two-third of RLS patients with iron deficiency showed persistence of the symptom even after iron normalization. Considering that longer duration of RLS symptoms and older age at RLS diagnosis were risk factors for symptom persistence, early intervention of iron deficiency in RLS is warranted.
Subject(s)
Female , Humans , Diagnosis , Early Intervention, Educational , Ferritins , Iron , Logistic Models , Restless Legs Syndrome , Risk FactorsABSTRACT
OBJECTIVE: It has been reported that untreated sleep-disordered breathing (SDB) deteriorates over time, however this remains contentious. The aim of the present study is to evaluate the clinical course of SDB in middle-aged and older SDB patients, and to identify how relevant factors contribute to the change in SDB severity. METHODS: Baseline and follow-up polysomnographic data of 56 untreated SDB patients (mean age, 61.2±5.71) were obtained retrospectively and the mean interval was 62.4±22.0 months. Subgroup analysis was performed based on the baseline severity, and the factors associated with the course of SDB were analyzed. RESULTS: At the baseline, 13 subjects were simple snorers, 15 had mild to moderate SDB, and 28 were severe SDB patients. While there was no significant change in apnea-hypopnea index (AHI) as a whole, subgroup analysis showed decrease of AHI in severe SDB patients (43.9±10.6 to 35.6±20.0, p=0.009). The change in supine time percent and baseline AHI were associated with the change in AHI (β=0.387, p=0.003; β=-0.272, p=0.037). CONCLUSION: Untreated SDB did not deteriorate over time with modest improvement in severe SDB. A proportion of severe SDB patients might expect decrease in SDB severity irrespective of changes in sleep position or body weight.
Subject(s)
Aged , Humans , Body Weight , Follow-Up Studies , Retrospective Studies , Sleep Apnea SyndromesABSTRACT
OBJECTIVE: The aim was to establish an optimal cut-off score of the Children's Depression Inventory (CDI) for detecting depression and rating severity in Korean adolescents. METHODS: A total of 468 students aged 12-16 years from 8 middle schools in Busan, Korea participated in this study. The Korean version of the CDI and Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version were used to evaluate depressive symptoms. Receiver-operating characteristics (ROC) analyses were conducted to evaluate case-finding performance and set the cut-off scores. RESULTS: ROC analyses demonstrated that the overall discrimination power of the CDI is good enough to evaluate adolescent depression. The CDI sum score of 20 was identified as the optimal screening cut-off score, where sensitivity was 0.83 and specificity was 0.89. This cut-off score could apply regardless of subjects' gender. The cut-off scores were examined in order of the depression severity: 15 for mild, 20 for moderate, and 25 for severe depression with high sensitivity and specificity. CONCLUSION: The CDI cut-off scores of our study can be recommended for screening depressed youth and rating the severity of depressive symptoms. The high negative predictive value suggested that the cut-off score of 20 would result in a small number of missed cases. Further studies are needed to ascertain these CDI cut-off scores for different age groups.
Subject(s)
Adolescent , Humans , Appointments and Schedules , Depression , Discrimination, Psychological , Korea , Mass Screening , Mood Disorders , ROC Curve , Schizophrenia , Sensitivity and SpecificityABSTRACT
OBJECTIVES: Restless legs syndrome (RLS) is a common sleep disorder in adults with diabetes. This study investigated the frequency of RLS and clinical correlations in children and adolescents with type 1 diabetes. METHODS: This study included 55 consecutive patients (21 males, age 12.6 +/- 3.4 years) with type I diabetes that were regularly treated at the Department of Pediatric Endocrinology. RLS was diagnosed by intensive interviews which also included the Epworth Sleepiness Scale (ESS) and International RLS Rating Scale (IRLSRS). Patients also received neurological examinations and laboratory tests for diabetes, iron metabolism and renal function. RESULTS: Thirteen patients (23.6%, 6 males) were compatible for the diagnostic criteria of RLS. None of the RLS patients showed abnormal findings in neurological evaluations and 7 patients had familial history of RLS. Demographic and laboratory findings were not different between the patients with or without RLS. The RLS group showed significantly increased ESS and IRLSRS scores. CONCLUSION: RLS was prevalent in children and adolescents with type I diabetes. The association between RLS and diabetes-related laboratory findings requires further investigation.
Subject(s)
Adolescent , Adult , Child , Humans , Male , Endocrinology , Iron , Metabolism , Neurologic Examination , Restless Legs SyndromeABSTRACT
OBJECTIVE: The aims of the present study are to investigate the rate of the psychiatric disorders in psychiatrically high-risk children and adolescents and to examine sex and age differences in the diagnosis of psychiatric disorders. METHODS: The participants included students aged 6-16 from the 27 elementary and the 45 middle schools in Busan, Korea. We screened psychopathology using the Korean version of Child Behavior Checklist (K-CBCL) or the Youth Self Report (K-YSR). A total of 2,912 students were selected as high-risk students on the basis of cut-off scores (T-score > or =60) for a total behavior problem score of K-CBCL/K-YSR. Of these high-risk students, 1,985 students participated in and completed individual diagnostic interviews. Psychiatric diagnosis was assessed using a Korean version of the Kiddie-Schedule for Affective Disorders and Schizophrenia. Multivariate logistic regression analysis was conducted to examine sex and age differences of psychiatric diagnosis. RESULTS: Based on sex, boys were more likely to have ADHD and girls were more likely to have depression. Based on age, children were more likely to have ADHD and adolescents were more likely to have affective disorder, conduct disorder, psychotic disorder, and anxiety disorders except separation anxiety disorder. CONCLUSION: This is the largest study to conduct face-to-face interviews with subjects and parent(s) among Korean studies in this field. The present study revealed significant differences across sex and age among specific psychiatric disorders in children and adolescents. Future population-based studies will be required to ascertain the sex- and age-related differences of psychiat prevalence.