Penile neoplasm associated with Equus caballus papillomavirus type 2 infection in a miniature Appaloosa: a case report

An 18-year-old miniature Appaloosa stallion presented with 6 months of history of sanguineous crusts on medial hind limbs and discomfort of micturition. Cauliflower-like and small masses were treated with cryotherapy for 6 months, but the regrowth of masses occurred. Subsequently, local excision via laser and topical treatment with 5% 5-fluorouracil for 5 months were followed. However, the horse was euthanized 4 months later due to regrowth of the masses. The mass was diagnosed as penile papilloma with cellular atypia and Equus caballus papillomavirus type 2 (EcPV-2) DNA was detected. This is the first report of equine penile neoplasm with EcPV-2 infection in Asia.

Effectiveness of the Korean-Patient Placement Criteria for Alcohol Use Disorders: A Prospective Exploratory Study

Objective@#Various patient placement criteria (PPC) have been developed to address alcohol use disorder (AUD), which has a high relapse rate and imposes substantial socioeconomic costs. Although research has shown PPC to be an effective tool, evidence supporting the Korean-PPC (K-PPC) is insufficient. This paper investigated whether treatment matching with the K-PPC was effective, based on variables related to AUD. @*Methods@#In total, 524 participants were evaluated using the 6 dimensions of the K-PPC and levels of care (LoC) were recommended based on the results. Participants whose treatment matched with the recommended LoC were classified into the matched group, and those whose treatment did not match were classified into the mismatched group. Subsequently, treatment was planned according to the determined LoC, and a total of 3 follow-up evaluations were conducted at 1 month, 3 months, and 6 months. @*Results@#There was no significant difference in the follow-up rate between the K-PPC matched group and the mismatched group. Of the variables measured by the 6 dimensions of the K-PPC, alcohol-related variables, depression, insight, and biomedical outcomes showed the most significant results (especially alcohol-related variables) from the baseline evaluation to the 6-month follow-up. In addition, the average adherence to the treatment program in the 6-month period was found to be higher in the matched group than in the mismatched group. @*Conclusion@#The K-PPC could be effective for placing patients and providing treatment by matching patient characteristics. Enhancing treatment program retention can also have a positive effect on clinical outcomes.

Public Perception Towards Drug Abuse in South Korea: The Effects of Overconfidence and Affirmation

Objective@#The abuse of prescription drugs and over-the-counter medicines has been a major issue addressed as a serious public health problem worldwide. This study explored factors contributing to substance abuse in Korea by examining the status of substance abuse among Korean adults and evaluating their knowledge, attitudes, and intentions toward substance abuse. @*Methods@#Data were collected online from a sample of participants 19 years old or older from May 20 to June 1, 2020 (n=1,020). The survey consisted of questions on demographics, perceptions of drug risk, motives for drug use, and attitudes toward drug addiction treatment. Principal component and multiple logistic regression analyses were used to explore the factors contributing to the perception of drug abuse. @*Results@#In the multivariate regression analysis, overconfidence in handling drug usage, acceptance of addictive substances, and affirmation of public support for drug abuse were associated with opioid abuse (Nagelkerke R2=0.486), and additionally affirmation of legal cannabis usage and motivation to use diet pills were associated with diet pill abuse (Nagelkerke R2=0.569). @*Conclusion@#The findings of this study suggest that the actual situation of substance abuse among Korean adults increases awareness of and attitudes toward drug use related to substance abuse.

Hyperarousal-state of Insomnia Disorder in Wake-resting State Quantitative Electroencephalography

Objective@#Insomnia is associated with elevated high-frequency electroencephalogram power in the waking state. Although affective symptoms (e.g., depression and anxiety) are commonly comorbid with insomnia, few reports distinguished objective sleep disturbance from affective symptoms. In this study, we investigated whether daytime electroencephalographic activity explains insomnia, even after controlling for the effects of affective symptoms. @*Methods@#A total of 107 participants were divided into the insomnia disorder (n = 58) and healthy control (n = 49) groups using the Mini-International Neuropsychiatric Interview and diagnostic criteria for insomnia disorder. The participants underwent daytime resting-state electroencephalography sessions (64 channels, eye-closed). @*Results@#The insomnia group showed higher levels of anxiety, depression, and insomnia than the healthy group, as well as increased beta [t(105) = −2.56, p = 0.012] and gamma [t(105) = −2.44, p = 0.016] spectra. Among all participants, insomnia symptoms positively correlated with the intensity of beta (r = 0.28, p ＜ 0.01) and gamma (r = 0.25, p ＜ 0.05) spectra. Through hierarchical multiple regression, the beta power showed the additional ability to predict insomnia symptoms beyond the effect of anxiety (ΔR2 = 0.041, p = 0.018). @*Conclusion@#Our results showed a significant relationship between beta electroencephalographic activity and insomnia symptoms, after adjusting for other clinical correlates, and serve as further evidence for the hyperarousal theory of insomnia. Moreover, resting-state quantitative electroencephalography may be a supplementary tool to assess insomnia.

The association between adverse childhood experiences and self-harm among South Korean children and adolescents: a cross-sectional study

Purpose@#Adolescent self-harm is a public health problem. Research suggests a link between adverse childhood experiences (ACEs) and self-destructive behaviors. Few studies, however, have examined the effects of ACEs on self-harm among Asian adolescents. This study explored the association between lifetime ACEs and a history of self-harm among Korean children and adolescents in elementary, middle, and high schools. @*Methods@#A cross-sectional, retrospective medical record review was conducted on a dataset of a national psychiatrist advisory service for school counselors who participated in the Wee Doctor Service from January 1 to December 31, 2020. The data were analyzed using multiple logistic regression to predict self-harm. @*Results@#Student cases (n=171) were referred to psychiatrists by school counselors for remote consultation. Multiple logistic regression analyses revealed that the odds of self-harm were higher among high school students (adjusted odds ratio [aOR]=4.97; 95% confidence interval [CI]=1.94-12.76), those with two or more ACEs (aOR=3.27; 95% CI=1.43-7.47), and those with depression (aOR=3.06; 95% CI=1.32-7.10). @*Conclusion@#The study's findings provide compelling evidence that exposure to ACEs can increase vulnerability to self-harm among Korean students. Students with a history of ACEs and depression, as well as high school students, require increased attention during counseling. School counselors can benefit from incorporating screening assessment tools that include questions related to ACEs and depression. Establishing a systematic referral system to connect students with experts can enhance the likelihood of identifying self-harm tendencies and offering the essential support to prevent self-harm.

Effect of a Motivational InterviewingBased Brief Intervention on Alcohol Use Behavior in Korean Internal Medicine Settings

A motivational interviewing (MI)-based brief intervention was performed with high-risk drinking outpatients screened at internal medicine settings in Korea after the doctor advised them to reduce alcohol consumption. Participants were assigned to a MI group or a control group where they received a brochure with information on the harm of high-risk drinking and tips on managing drinking habits. Four-week follow-up results showed that Alcohol Use Disorders Identification Test-Concise (AUDIT-C) scores decreased in the MI group and the control group compared to baseline scores. The difference between groups was not significant; however, group by time interaction was significant between the two groups: the slope of decreasing AUDIT-C scores over time was greater in the intervention group than in the control group (P = 0.042). The findings suggest that short comments received from doctors might be a key component in performing brief interventions for high-risk drinking management in Korean clinical settings.

Post-percutaneous core needle biopsy sputum cytology: diagnostic value and factors for positive prediction in diagnosing malignancy / 고신대학교의과대학학술지

Background@#This study evaluated the diagnostic yield and positive predictive factors of post-percutaneous core needle biopsy (PCNB) sputum cytology in diagnosing malignancy. @*Methods@#This retrospective study included patients who underwent PCNB at a single center from January 2014 to March 2022. Patient demographics, lung lesion characteristics on computed tomography, underlying lung disease, post-PCNB complications, histopathologic results of PCNB, post-PCNB sputum specimens, and final diagnoses were reviewed. The diagnostic yields and related factors were analyzed. @*Results@#Overall, 177 consecutive patients with sputum specimens obtained after PCNB for intrapulmonary lesions were enrolled. Among them, 152 patients had a final diagnosis of malignancy. Diagnostic sputum specimens with atypical or malignant cells were obtained in 12 patients. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of sputum cytology were 7.89%, 100%, 20.90%, 100%, and 15.15%, respectively. Lesion size, air-bronchogram, lesion multiplicity, and the cell type of squamous cell and adenocarcinoma differed significantly between the groups with diagnostic versus non-diagnostic sputum (p<0.05). The lesion size (odds ratio [OR], 1.035; 95% confidence interval [CI], 1.008–1.064; p=0.013), presence of air-bronchogram (OR, 23.485; 95% CI, 2.532–217.316; p=0.005), and squamous cell carcinoma (OR, 7.397; 95% CI, 1.773–30.865; p=0.006) were significantly associated with a diagnostic sputum specimen post-PCNB. @*Conclusions@#Although post-PCNB sputum cytology had low sensitivity in diagnosing lung cancer, it showed diagnostic results in some peripheral lung cancer patients who have squamous cell types, relatively large tumors, and air-bronchograms in the lesions.

Social Stigma and Discrimination Toward People With Drug Addiction: A National Survey in Korea

Objective@#This study aims to understand the attitudes, stigma, and discrimination of the general adult population toward drug addiction. @*Methods@#We conducted a cross-sectional nationwide survey with 1,020 Korean adults using an Internet web-based panel. Self-reported data were collected on demographics, experience with substance abuse, perceptions of narcotic analgesic use, beliefs about the legalization of cannabis use, coping with substance abuse and addiction, and perceptions of drug risks. All statistical analysis in this study utilized the IBM SPSS Statistics 26 program. @*Results@#In this study, 1.6% of the participants reported abuse of opioid analgesics, 88.0% reported negative perceptions of drug addiction, and 76.9% reported agreeing to unfair treatment of drug addicts. Logistic regression analysis found that perceived stigma was more prevalent among women (odd ratio [OR]=2.087, p<0.01), old adults (OR=1.939, p<0.01), those with no personal experience of opioid misuse (OR=8.172, p<0.05), and those who were non-smoking (OR=2.011, p<0.01). In addition, the discriminatory attitude was more prevalent among participants with higher income (OR=1.989, p<0.001) and those who are non-smoking (OR=1.608, p<0.05). @*Conclusion@#This study provides information and guidelines for public intervention in drug addiction by identifying factors influencing social stigma and discriminatory behaviors toward drug addiction. The findings suggest that education on drug addiction prevention for the general adult population is necessary, and this education should include knowledge on coping with drug addiction and reducing stigma and discrimination toward drug addicts.

A Literature Review on the Efficacy and Related Neural Effects of Pharmacological and Psychosocial Treatments in Individuals With Internet Gaming Disorder

Objective@#Internet gaming disorder (IGD) has attracted considerable attention as a serious mental and public health issue worldwide. Currently, there are no established treatment guidelines for IGD. Herein, we review the latest findings on the efficacy and related neural effects of pharmacological and psychosocial treatments for individuals with IGD. @*Methods@#A database search of relevant studies published between 2007 and 2020 was conducted using PubMed and Google Scholar. Twenty-seven studies were reviewed for current evidence related to the efficacy and neural effects of pharmacological and psychosocial IGD treatments. @*Results@#Pharmacological studies suggest that bupropion may play a significant role in IGD. Additionally, nuclear imaging studies on IGD have demonstrated functional impairment of the dopamine system, providing a neurobiological basis for the efficacy of dopamineenhancing drugs. Among the various psychosocial interventions, current evidence suggests that cognitive behavioral therapy may be an effective intervention for IGD. Cognitive behavioral therapy and bupropion were found to influence resting-state functional connectivity within the cortico-subcortical circuit and default mode network, suggesting a possible neural mechanism. Innovative approaches, including virtual reality treatment, residential camps, voluntary abstinence, and transcranial direct current stimulation, have shown promising results. However, methodological limitations, such as the absence of proper controls, small sample sizes, short duration, inconsistency of inclusion criteria across studies, and self-report measures of outcome, hamper conclusions regarding the efficacy of treatments. @*Conclusion@#Ongoing basic research and clinical trials overcoming these limitations could add to the existing knowledge on IGD and contribute to the development of evidence-based treatments.

Molecular and serological surveillance of equine piroplasmosis in the Republic of Korea between 2016 and 2017

Equine piroplasmosis (EP) is caused by Babesia caballi and Theileria equi infection. We investigated antigen and antibody of EP in horses in the Republic of Korea during 2016-2017. Antigen and antibody of T. equi was detected 0.06% (1/1,650). Phylogenetic analysis of 18S rRNA revealed that the T. equi was highly homologous with the strains from China, Mongolia, and Spain. Two Theileria spp. were also detected and highly homologous with T. buffeli, T. luwehshuni, and T. orientalis.

Reliability, Validity, and Unidimensionality of the Korean Version of the Pornography Craving Questionnaire Based on the Classical Test Theory and Item Response Theory

Objective@#This study aimed to evaluate the reliability and validity of the Korean version of the Pornography Craving Questionnaire (K-PCQ) using classical test theory and item response theory. @*Methods@#The goodness of fit test and differential item functioning (DIF) analysis based on the Rasch model, confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and correlation analysis were used to test its reliability and validity. @*Results@#Response data from 226 students were analyzed. According to the goodness of fit test, the outfit mean square value of only one item, Item 11, was greater than 2. The CFA results revealed that all items of the K-PCQ measured a single construct. The EFA results revealed that the K-PCQ had excellent internal reliability. The DIF analysis results showed that the measurement of pornography craving using the K-PCQ did not differ based on gender. The result of Poly-DIMTEST supported the unidimensionality of the K-PCQ. The cut-off value of pornography craving was suggested as a measure of -0.0908 which corresponds to 46 (54.8%) out of a maximum score of 84. @*Conclusion@#The items of the K-PCQ are unidimensional and have good reliability and validity. The K-PCQ will be useful in clinical practice and research as a screening tool for pornography craving.

Internet Addiction and Its Associations with Clinical and Psychosocial Factors in Medical Students

Objective@#Excessive internet use has been associated with various psychiatric symptoms and psychosocial factors. This study aimed to investigate the prevalence of internet addiction (IA) and its associations with clinical (depression/social anxiety) and psychosocial (self-esteem/perceived social support) factors in medical students. @*Methods@#In total, 408 medical students at one university in Korea were included in this study. IA symptoms were assessed with Young’s Internet Addiction Test, and scores of 50 or higher were considered to indicate IA. Participants were asked to complete the Beck Depression Inventory, Social Phobia Inventory, Rosenberg Self-Esteem Scale, and Duke-University of North Carolina Functional Social Support Questionnaire. A logistic regression model was constructed to examine the impact of clinical and psychosocial factors on IA. @*Results@#Forty-seven participants (11.5%) were identified as having IA. Self-esteem was associated with a lower risk of IA, whereas depression and social anxiety were associated with a higher risk of IA. Depression, social anxiety, low self-esteem, and low perceived social support were found to be significant correlates of IA. Young’s Internet Addiction Test score positively correlated with Beck Depression Inventory and Social Phobia Inventory scores, but negatively correlated with Rosenberg Self-Esteem Scale and Duke-University of North Carolina Functional Social Support Questionnaire scores. Furthermore, the prevalence of IA was highest in first-year medical students. @*Conclusion@#This study revealed the possible risk and protective factors of IA. Our findings indicate that strengthening self-esteem and reducing depression and social anxiety may contribute to the prevention and management of IA in medical students.

Molecular and serological surveillance of equine piroplasmosis in the Republic of Korea between 2016 and 2017

Equine piroplasmosis (EP) is caused by Babesia caballi and Theileria equi infection. We investigated antigen and antibody of EP in horses in the Republic of Korea during 2016-2017. Antigen and antibody of T. equi was detected 0.06% (1/1,650). Phylogenetic analysis of 18S rRNA revealed that the T. equi was highly homologous with the strains from China, Mongolia, and Spain. Two Theileria spp. were also detected and highly homologous with T. buffeli, T. luwehshuni, and T. orientalis.

Reliability, Validity, and Unidimensionality of the Korean Version of the Pornography Craving Questionnaire Based on the Classical Test Theory and Item Response Theory

Objective@#This study aimed to evaluate the reliability and validity of the Korean version of the Pornography Craving Questionnaire (K-PCQ) using classical test theory and item response theory. @*Methods@#The goodness of fit test and differential item functioning (DIF) analysis based on the Rasch model, confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and correlation analysis were used to test its reliability and validity. @*Results@#Response data from 226 students were analyzed. According to the goodness of fit test, the outfit mean square value of only one item, Item 11, was greater than 2. The CFA results revealed that all items of the K-PCQ measured a single construct. The EFA results revealed that the K-PCQ had excellent internal reliability. The DIF analysis results showed that the measurement of pornography craving using the K-PCQ did not differ based on gender. The result of Poly-DIMTEST supported the unidimensionality of the K-PCQ. The cut-off value of pornography craving was suggested as a measure of -0.0908 which corresponds to 46 (54.8%) out of a maximum score of 84. @*Conclusion@#The items of the K-PCQ are unidimensional and have good reliability and validity. The K-PCQ will be useful in clinical practice and research as a screening tool for pornography craving.

Internet Addiction and Its Associations with Clinical and Psychosocial Factors in Medical Students

Objective@#Excessive internet use has been associated with various psychiatric symptoms and psychosocial factors. This study aimed to investigate the prevalence of internet addiction (IA) and its associations with clinical (depression/social anxiety) and psychosocial (self-esteem/perceived social support) factors in medical students. @*Methods@#In total, 408 medical students at one university in Korea were included in this study. IA symptoms were assessed with Young’s Internet Addiction Test, and scores of 50 or higher were considered to indicate IA. Participants were asked to complete the Beck Depression Inventory, Social Phobia Inventory, Rosenberg Self-Esteem Scale, and Duke-University of North Carolina Functional Social Support Questionnaire. A logistic regression model was constructed to examine the impact of clinical and psychosocial factors on IA. @*Results@#Forty-seven participants (11.5%) were identified as having IA. Self-esteem was associated with a lower risk of IA, whereas depression and social anxiety were associated with a higher risk of IA. Depression, social anxiety, low self-esteem, and low perceived social support were found to be significant correlates of IA. Young’s Internet Addiction Test score positively correlated with Beck Depression Inventory and Social Phobia Inventory scores, but negatively correlated with Rosenberg Self-Esteem Scale and Duke-University of North Carolina Functional Social Support Questionnaire scores. Furthermore, the prevalence of IA was highest in first-year medical students. @*Conclusion@#This study revealed the possible risk and protective factors of IA. Our findings indicate that strengthening self-esteem and reducing depression and social anxiety may contribute to the prevention and management of IA in medical students.

Assessment and Treatment of Alcohol Withdrawal Syndrome / 대한소화기학회지

Alcohol withdrawal syndrome (AWS) is the most common and well-known condition occurring after intentional or unintentionalcessation or decreasing heavy drinking. Approximately 5-10% of these people are suffering from serious medical and psychiatricproblems, withdrawal seizures, perceptual disturbances, and delirium tremens. Despite acute medical conditions with the highmortality of severe AWS, proper management could decrease the severity and mortality of AWS. The Clinical Institute withdrawalassessment for alcohol-revised version is a valid, reliable, and sensitive instrument for assessing the clinical course and thetreatment monitoring of alcohol withdrawal. Benzodiazepine is the pharmacotherapy of choice for alcohol withdrawal. Diazepamor lorazepam treatment is best initiated early in the course of alcohol withdrawal to prevent progression to more severewithdrawal. There are three strategies for the pharmacotherapy of AWS. After the treatment of AWS, most patients should bemanaged or treated by the continuing care, including the psychosocial treatments, community-based management, and programsfor preventing recurrence of AWS.

Genotype-specific neutralizing antibody titers against Japanese encephalitis virus genotypes 1 and 3 in horses immunized with a genotype 3 vaccine

Purpose@#Japanese encephalitis is one of the most important mosquito-borne and zoonotic diseases in Asia and the Pacific region. Although the dominant Japanese encephalitis virus (JEV) genotype has shifted from G3 to G1 in Korea since 1990, a G3 strain (Anyang 300) has been used in vaccines for horses for almost 40 years. This study aimed to investigate the seroconversion rates and geometric mean titers (GMTs) of virus-neutralizing antibodies (VNAs) against JEV G1 and G3 in horses immunized with the G3 vaccine. @*Materials and Methods@#Serum samples of 1,231 horses immunized with the Anyang 300 vaccine were collected in 2018. VNA titers against JEV KV1899 (G1) and Anyang 300 (G3) were measured in all serum samples using the virus neutralization test. Titers were analyzed according to blood sampling time (prior to and following annual revaccination), age, and region. @*Results@#Rates of VNA titer >10 were 45.1% and 77.8% for G1, and 49.1% and 82.9% for G3 in samples taken before and after revaccination, respectively. GMTs of genotype-specific VNAs against JEV G1 and G3 were 8.3 and 11.6 before revaccination and rose to 27.2 and 65.4 following revaccination. Overall sero-positivity did not significantly differ between genotypes, but GMTs significantly differed among genotypes and sampling times. No significant difference was found in GMTs among age groups or regions. @*Conclusion@#Genotype-specific neutralizing antibody titers against JEV G1 and G3 differed significantly in horses immunized with the G3 vaccine. Antigenic differences between genotypes could reduce the vaccine’s efficacy, requiring the development of a new vaccine.

Genotype-specific neutralizing antibody titers against Japanese encephalitis virus genotypes 1 and 3 in horses immunized with a genotype 3 vaccine

Purpose@#Japanese encephalitis is one of the most important mosquito-borne and zoonotic diseases in Asia and the Pacific region. Although the dominant Japanese encephalitis virus (JEV) genotype has shifted from G3 to G1 in Korea since 1990, a G3 strain (Anyang 300) has been used in vaccines for horses for almost 40 years. This study aimed to investigate the seroconversion rates and geometric mean titers (GMTs) of virus-neutralizing antibodies (VNAs) against JEV G1 and G3 in horses immunized with the G3 vaccine. @*Materials and Methods@#Serum samples of 1,231 horses immunized with the Anyang 300 vaccine were collected in 2018. VNA titers against JEV KV1899 (G1) and Anyang 300 (G3) were measured in all serum samples using the virus neutralization test. Titers were analyzed according to blood sampling time (prior to and following annual revaccination), age, and region. @*Results@#Rates of VNA titer >10 were 45.1% and 77.8% for G1, and 49.1% and 82.9% for G3 in samples taken before and after revaccination, respectively. GMTs of genotype-specific VNAs against JEV G1 and G3 were 8.3 and 11.6 before revaccination and rose to 27.2 and 65.4 following revaccination. Overall sero-positivity did not significantly differ between genotypes, but GMTs significantly differed among genotypes and sampling times. No significant difference was found in GMTs among age groups or regions. @*Conclusion@#Genotype-specific neutralizing antibody titers against JEV G1 and G3 differed significantly in horses immunized with the G3 vaccine. Antigenic differences between genotypes could reduce the vaccine’s efficacy, requiring the development of a new vaccine.

Clinical characteristics of intentional self-harm inpatient with lethal methods

OBJECTIVE: The aim of this study was to identify the latent class, according to the risk factors, of the patients hospitalized due to intentional self-harm by lethal means. METHODS: The risk factors were derived by categorizing the intentional self-harming measures by lethal (hanging, pesticide poisoning, jumping, and drowning) and non-lethal (drug poisoning and stab) measures and comparing the demographics, diseased state, and suicide-related characteristics. Latent class analysis was performed to identify the type of intentional self-harm. RESULTS: Male (sex), elderly (age), rural (residing location), and comorbid diseases were found to be the risk factors for fatal injuries. For this, four latent classes were modeled. Factors, such as the age group between 20 to 40 years, women, and family conflict were included in the first class. The second class included the age group between 30 to 50 years, men, and financial problems. The third class covered the age group between 60 to 70 years and comorbidity. The fourth class contained the age group of 10 to 50 years, women, and mental problems. The rate of suicide and choice of fatal suicide was ranked in the order of 3 (62.7%, 21.5%), 2 (59.8%, 13.9%), 4 (36.8%, 5.7%), and 1 (29.5%, 5.9%). CONCLUSION: A lethal mean access control policy needs to be established for the high-risk group of self-harm. Moreover, establishing an emergency room-community link prevention policy could help reduce the re-suicide attempt among suffering patients.

Transitions in Problematic Internet Use: A One-Year Longitudinal Study of Boys

OBJECTIVE: Longitudinal studies may help elucidate the factors associated with Problematic Internet Use (PIU); however, little prospective research has been conducted on the subject. The aim of the current study was to prospectively examine PIU in children/adolescents and identify the possible risk factors associated with transitions in PIU severity. METHODS: 650 middle-school boys were surveyed at two points one year apart and assessed for PIU using the Internet Addiction Proneness Scale for Youth (KS-II) and on other psychological characteristics. RESULTS: We found that 15.3% at baseline and 12.4% at one year met the criteria for at-risk/high-risk PIU (ARHRPIU). Both the persistent-ARHRPIU and emerging-ARHRPIU groups revealed greater depressive, motor impulsive, and smart-phone-addiction tendencies than the remitting-ARHRPIU group or the persistent low-risk group. In addition, we found that individuals exhibiting higher hyperkinetic attention-deficit/hyperactivity disorder (ADHD) scores were less likely to remit from ARHRPIU, and that individuals exhibiting more ADHD-related cognitive dysfunction and reporting fewer Internet-game-free days were more likely to demonstrate an emergence of ARHRPIU. CONCLUSION: The present findings support previous studies in that specific negative-health features are linked to transitions in ARHRPIU. Furthermore, these findings suggest that intervention is needed and may be best targeted at specific groups of youths.