Prevalence and Associated Factors of Depression and Anxiety Among Healthcare Workers During the Coronavirus Disease 2019 Pandemic: A Nationwide Study in Korea.

BACKGROUND: A healthcare system's collapse due to a pandemic, such as the coronavirus disease 2019 (COVID-19), can expose healthcare workers (HCWs) to various mental health problems. This study aimed to investigate the impact of the COVID-19 pandemic on the depression and anxiety of HCWs. METHODS: A nationwide questionnaire-based survey was conducted on HCWs who worked in healthcare facilities and public health centers in Korea in December 2020. Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure depression and anxiety. To investigate factors associated with depression and anxiety, stepwise multiple logistic regression analysis was performed. RESULTS: A total of 1,425 participating HCWs were included. The mean depression score (PHQ-9) of HCWs before and after COVID-19 increased from 2.37 to 5.39, and the mean anxiety score (GAD-7) increased from 1.41 to 3.41. The proportion of HCWs with moderate to severe depression (PHQ-9 ≥ 10) increased from 3.8% before COVID-19 to 19.5% after COVID-19, whereas that of HCWs with moderate to severe anxiety (GAD-7 ≥ 10) increased from 2.0% to 10.1%. In our study, insomnia, chronic fatigue symptoms and physical symptoms after COVID-19, anxiety score (GAD-7) after COVID-19, living alone, and exhaustion were positively correlated with depression. Furthermore, post-traumatic stress symptoms, stress score (Global Assessment of Recent Stress), depression score (PHQ-9) after COVID-19, and exhaustion were positively correlated with anxiety. CONCLUSION: In Korea, during the COVID-19 pandemic, HCWs commonly suffered from mental health problems, including depression and anxiety. Regularly checking the physical and mental health problems of HCWs during the COVID-19 pandemic is crucial, and social support and strategy are needed to reduce the heavy workload and psychological distress of HCWs.

Emotional and Behavioral Correlates of Exposure to Electronic Media in School-Aged Children: A Prospective Study.

BACKGROUND: Exposure to electronic media is increasing from early childhood. This study aimed to examine the association between screen time and behavioral outcomes in school-aged children with a prospective birth-cohort. METHODS: We examined the association between screen time and behavioral outcomes in school-aged children with a Korean birth-cohort study. Participants were 2,150 children, recruited during their fetal period, assessed annually for developmental outcomes. Media exposure was assessed at T4 (3.2 y/o), T8 (7.3 y/o), and T10 (9.4 y/o). After exclusions for missing data, 1,368 children were categorized into four groups (Low-Low, Low-High, High-Low, and High-High) based on average daily media time in early childhood and during schooldays, respectively. Children's temperament was assessed from T1 (0.5 y/o) to T4. Emotional and behavioral outcomes were assessed using the Child Behavior Checklist (DSM-oriented subscales) at T8 and T10. RESULTS: We found that early-years temperament was generally similar between the media-time groups: they only differed significantly on Activity at T1 and Emotionality at T2 (1.2 y/o). However, compared to the Low-Low group, the Low-High group had significantly higher odds of high-risk scores for Conduct Problems (increased odds ratios [ORs] of 1.82 at T8 and 1.83 at T10) and Anxiety Problems (increased ORs of 1.60 at T8 and 1.82 at T10). Self-rated self-esteem and overall happiness at T10 also significantly differed among the four groups. CONCLUSION: Our findings suggest the negative impacts of media exposure on the emotional and behavioral development of school-aged children, which substantiates the guidelines that restrict media exposure during childhood.

The Relationship Between Childhood Trauma Experience and Complicated Grief: The Importance of Psychological Support for Individuals Coping With Pet Loss in Korea.

BACKGROUND: Loss of companion animals can result in various psychological reactions, including complicated grief, depression, anxiety, and insomnia. However, research on the prevalence of patients requiring clinical intervention is limited. Moreover, research examining the relationship between childhood trauma and psychological symptoms after pet loss is lacking. Therefore, this study aimed to investigate the rates of clinically significant psychological distress after pet loss and the impact of childhood trauma on adults who have experienced pet loss. METHODS: An online survey was conducted with non-clinical adult participants who had experienced the loss of a companion animal. Psychiatric characteristics were evaluated using standardized assessments, including the Inventory of Complicated Grief (ICG), the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), and the Insomnia Severity Index (ISI). Childhood trauma was evaluated using the Childhood Trauma Questionnaire (CTQ). RESULTS: In a sample of 137 individuals who had experienced pet loss, the percentages of those who exceeded the cutoff points were 55% for the ICG, 52% for the PHQ-9, 40% for the GAD-7, and 32% for the ISI. The group that reported childhood trauma exhibited significantly higher scores on the ICG (t = 2.16, P = 0.032), PHQ-9 (t = 3.05, P = 0.003), GAD-7 (t = 2.61, P = 0.010), and ISI (t = 2.11, P = 0.037) than in the group without childhood trauma. For participants who experienced pet loss for less than one year, there was no significant difference in the ICG between the trauma and non-trauma groups, as both had extremely high scores. However, the trauma group had a significantly higher PHQ-9 (t = 2.58, P = 0.012) than the non-trauma group. In contrast, for participants who experienced pet loss for more than one year, the trauma group had a significantly higher ICG (t = 2.22, P = 0.03) than the non-trauma group, while there was no significant difference in the PHQ-9. Additionally, the emotional abuse scores on the CTQ were most significantly correlated with the ICG scores even after controlling for depressive symptoms. CONCLUSION: People who experienced pet loss had significant psychological symptoms, ranging from 32% to 55%. Childhood trauma experiences affect complicated grief, depressive symptoms, anxiety symptoms, insomnia and prolonged grief disorder after pet loss. After pet loss, people with childhood trauma may require more psychological help than those without trauma.

Developing an Attention Assessment Tool for Individuals With Autism Spectrum Disorder Using Timbre, Rhythm, and Pitch.

BACKGROUND: Music is regarded as a beneficial tool for assessing the clinical symptoms and communication skills in individuals with autism spectrum disorder (ASD) or autism. The present study developed a music-based attention test (MAT) for individuals with autism using music parameters and the algorithm of the comprehensive attention test (CAT). METHODS: We recruited 51 autistic individuals and 50 neurotypical individuals to participate in the CAT, MAT, and social intelligence tests. The reliability and validity of the MAT were assessed using exploratory factor analysis, concurrent validity, and criterion-related validity. RESULTS: The MAT had sound internal consistency (high Cronbach's α = 0.948). In addition, the MAT had suitable concurrent validity in the correlation between CAT and MAT, as well as good criterion validity when attention was measured using the MAT and was compared between autistic individuals and neurotypical individuals. Attention evaluated using the MAT was associated with the social quotient in individuals with autism. CONCLUSIONS: The MAT could be a relevant tool for gauging attention in individuals with ASD. Furthermore, attention determined using the MAT may be correlated with social quotient in autistic individuals. Future studies should consider that using music in the field of attention could improve the social quotient of individuals with autism.

The Association Between Temperament and Characteristics, Smartphone App Use Patterns and Academic Performance of University Students.

BACKGROUND: Smartphone use patterns may predict daily life efficacy and performance improvements in sports. Additionally, personal characteristics may be associated with smartphone overuse. METHODS: We investigated the correlation between the temperament and character inventory (TCI) and academic performance using smartphone log data. We hypothesized that the elite and general groups, divided based on academic performance, differed according to the TCI and downloadable smartphone apps (applications). Additionally, we hypothesized a correlation between smartphone app usage patterns and TCI. A total of 151 students provided smartphone log data of the previous four weeks. They also completed the TCI and provided academic records of the previous year. RESULTS: The first and second most frequently used apps by both groups of students were social networking and entertainment, respectively. Elite students scored higher on novelty seeking, reward dependence, persistence, self-directedness, and self-transcendence than general students. In all participants, the usage time of serious apps was correlated with the scores for novelty seeking (r = 0.32, P < 0.007), reward dependence (r = 0.32, P < 0.007), and self-transcendence (r = 0.35, P < 0.006). In the elite group, the usage time of serious apps was correlated with the scores for novelty seeking (r = 0.45, P < 0.001), reward dependence (r = 0.39, P = 0.022), and self-transcendence (r = 0.35, P = 0.031). In the general group, the usage time of serious apps was correlated only with self-transcendence (r = 0.32, P < 0.007). CONCLUSION: High usage time of serious apps can help sports majors to excel academically. Particularly among sports majors, serious apps are related to activity, the desire for rewards and recognition, and the tendency to transcend themselves.

Associations among exposure to television or video, language development, and school achievement in childhood: a prospective birth cohort study.

PURPOSE: Exposure to electronic media, which begins in early childhood, has been gradually increasing. This study investigated the associations between time watching television or video (TV time), children's language development, and school achievement using a large prospective design. METHODS: The participants underwent annual assessment from birth (T1; 5.5 months) to T8 (87.9 months). We used a parental questionnaire to evaluate TV time annually from T3 (2.2 years) to T8 (7.3 years), by the item asking "How many hours does your child usually spend a day watching TV or videos?". Children were grouped by TV time using group-based trajectory analysis. Among 2150 participants, 1087 were included in the final analysis. The Korean version of the Denver II and the Korean-Ages and Stages questionnaires were administered to evaluate early childhood development (T1 to T3). The Receptive and Expressive Vocabulary Test was used to assess children's language development at T8. Questionnaires completed by both parents and teachers were used to evaluate school achievement at T8. RESULTS: Participants were divided into "Low Descending" (LD), "Medium Flat" (MF), "High Ascending" (HA), and "Extremely High Descending" (XHD) groups. Early language development at T1 and T2 did not significantly differ among all groups. However, language development at T3 and T8, and school achievement at T8 differed significantly, and were the highest in LD and lowest in HA. CONCLUSION: We found a negative association between greater TV time and children's language and cognitive development. Thus, unchecked TV exposure could be detrimental to childhood cognitive development.

Development and Verification of an Internet Game Literacy Scale.

BACKGROUND: Education on internet games for parents and internet game literacy are needed to prevent problematic internet game playing in Korea. We created an 18-item Internet Game Literacy Scale (IGLS). It is a valuable tool for assessing the positive and negative aspects of internet game play. We aimed to determine the validity of the IGLS and the cut-off for the tendency for internet gameplay. METHODS: An online research company gathered data from 300 participants. Factor analysis, including Cronbach's α and consistency coefficient, exploratory factor analysis, and confirmatory factor analysis were conducted to verify the 18 items of the IGLS. Additionally, a K-means cluster analysis was performed to determine the cut-off values for positive and negative IGLS scores. RESULTS: The 18 items of the IGLS were proven to be reliable, as evidenced by a high Cronbach's alpha (α = 0.892). The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.903, and Bartlett's test of sphericity was good (χ² = 1,623.314, P < 0.001). All 18 items were segregated into two factors, with nine items each. The eigenvalue of all 18 items was significant at > 0.4. In the analysis of the validity of the 18-item IGLS with confirmatory factor analysis (CFA) (maximum likelihood estimation, with an oblique method), the fit indices of the standard three-factor model reached acceptable standards. The cut-off point of the total score between the low positive and average positive groups was 23, and the cut-off point of the total score between the average positive and high positive groups was 30. The cut-off point of the total score between the low negative and the average negative groups was 24. The cut-off point of the total score between the average negative group and the high negative group was 32. CONCLUSION: The study assessed the reliability and validity of the IGLS and suggested a cut-off for low, average, and high Internet game literacy degree with 300 Korean adults aged 21-49 years. The current results suggest that the IGLS has good internal consistency and a proper cut-off for positive and negative internet game literacy degrees.

Psychosocial Support during the COVID-19 Outbreak in Korea: Activities of Multidisciplinary Mental Health Professionals.

As of April 18, 2020, there have been a total of 10,653 confirmed cases and 232 deaths due to coronavirus disease 2019 (COVID-19) in Korea. The pathogen spread quickly, and the outbreak caused nationwide anxiety and shock. This study presented the anecdotal records that provided a detailed process of the multidisciplinary teamwork in mental health during the COVID-19 outbreak in the country. Psychosocial support is no less important than infection control during an epidemic, and collaboration and networking are at the core of disaster management. Thus, a multidisciplinary team of mental health professionals was immediately established and has collaborated effectively with its internal and external stakeholders for psychosocial support during the COVID-19 outbreak.

A Comparison of Risk and Protective Factors for Excessive Internet Game Play between Koreans in Korea and Immigrant Koreans in the United States.

BACKGROUND: Studying immigrants may have the potential to explore how cultural and environmental changes affect the internet game play patterns of individuals in the two countries. We planned to compare risk and preventive factors for Internet Gaming Disorder (IGD) between Korean adolescents in Korea and immigrant Koreans in the US. METHODS: Ninety-four Koreans and 133 immigrant Koreans were recruited. Independent factors consisted of five domains including demographic data, physical activity, academic, art, and music activities, psychological factors, and game and media play. The dependent variable in the current study was the high-risk group of IGD, which was assessed with Young's Internet Addiction Scale scores. To determine the protective and risk factors for IGD, we performed a multiple logistic regression analysis using the high-risk group as the dependent variable. RESULTS: Five domains affected the risk for IGD in Korean and immigrant Korean groups. Vigorous physical activity was the strongest protective factor for IGD in the Korean group, while media activity was the strongest protective factor for IGD in immigrant Koreans in the US. CONCLUSION: The results indicate that internet gaming problems might be affected by environmental factors and it is recommended that gaming activity is substituted with physical activity, extracurricular classes, books, and music.

Validation Study of a Korean Version of the Abbreviated University of California, Los Angeles, PTSD Reaction Index (Abb-UCLA-PTSD RI) for Adolescents.

BACKGROUND: We aimed to verify a Korean version of the Abbreviated University of California, Los Angeles, Post-Traumatic Stress Disorder Reaction Index (Abb-UCLA-PTSD RI-Korean version) among Korean adolescents to assess post-traumatic stress in this population. METHODS: We recruited 1,254 adolescents who completed the Abb-UCLA-PTSD RI-Korean version scale, the Child Report of Post-Traumatic Symptoms (CROPS), the Lifetime Incidence of Traumatic Events (LITE), and the Children's Depression Inventory (CDI). Test-retest reliability was computed for a randomly selected 314 participants. Among all the students, 765 were included in the analysis because 143 students were classified in the normative group (LITE 1) and 622 were in the traumatized group (LITE 4). RESULTS: The internal consistencies of the nine-item and eight-item versions of the Abb-UCLA PTSD RI-Korean version were found to be high (Cronbach's α = 0.843 and 0.842, respectively). The criterion-related validity was based on comparison of the Abb-UCLA PTSD RI total scores between the normative and trauma groups. For the eight-item version, the normative group (4.6 ± 4.6) and the traumatized group (8.8 ± 6.0) demonstrated better criterion-related validity than those in the nine-item version (4.5 ± 4.3 and 8.5 ± 5.0, respectively). The test-retest reliability of the eight-item version was better than the nine-item version (r = 0.85 vs. 0.77). A two-factor model with eight items (two items regarding sleep, and the other six items made up the second factor) showed the best fit. CONCLUSION: Our results indicate that the eight-item Abb-UCLA PTSD RI-Korean version is a useful screening tool for post-traumatic stress in Korean adolescents.

Five Months Follow-up Study of School-based Crisis Intervention for Korean High School Students Who Experienced a Peer Suicide.

BACKGROUND: The purpose of this study was to examine post-traumatic stress, depression, anxiety, and complicated grief in Korean high school students who experienced a peer suicide. METHODS: A total of 956 students were included in the statistical analysis. One week after a peer suicide, a school-based crisis intervention program was conducted. The cohort was followed-up at one week and five months after a peer suicide. The program consists of screening tests, educational sessions, and further interview with psychiatric specialists for the selected group. Screening tests were conducted for all students to measure the Child Report of Post-traumatic Symptoms (CROPS), the post-traumatic stress symptoms (The University of California at Los Angeles post-traumatic stress disorder [PTSD] reaction index; UCLA-PTSD-RI), the anxiety symptoms (The Korean-Beck Anxiety Inventory; K-BAI), the depressive symptoms (The Korean-Beck Depression Inventory-II; K-BDI-II), and the complicated grief reaction (The Inventory of Complicated Grief; ICG). For statistical analysis, the SPSS Statistics 21.0 program was used. RESULTS: At baseline and five months follow-ups, 8.6% and 2.9% of the students showed post-traumatic stress symptoms. At five months follow-up, there was a statistically significant decline in the post-traumatic stress symptoms, anxiety, depression, and complicated grief among the 'trauma group.' A higher proportion of the female students showed post-traumatic stress symptoms after the incident of peer suicide than the male students. CONCLUSION: School-based crisis intervention helps improvement of trauma-related symptoms. It might be an effective way to prevent suicide spreading among students by alleviating trauma-related symptoms.

Comparison of Electroencephalography (EEG) Coherence between Major Depressive Disorder (MDD) without Comorbidity and MDD Comorbid with Internet Gaming Disorder.

Internet gaming disorder (IGD) has many comorbid psychiatric problems including major depressive disorder (MDD). In the present study, we compared the neurobiological differences between MDD without comorbidity (MDD-only) and MDD comorbid with IGD (MDD+IGD) by analyzing the quantitative electroencephalogram (QEEG) findings. We recruited 14 male MDD+IGD (mean age, 20.0 ± 5.9 years) and 15 male MDD-only (mean age, 20.3 ± 5.5 years) patients. The electroencephalography (EEG) coherences were measured using a 21-channel digital EEG system and computed to assess synchrony in the frequency ranges of alpha (7.5-12.5 Hz) and beta (12.5-35.0 Hz) between the following 12 electrode site pairs: inter-hemispheric (Fp1-Fp2, F7-F8, T3-T4, and P3-P4) and intra-hemispheric (F7-T3, F8-T4, C3-P3, C4-P4, T5-O1, T6-O2, P3-O1, and P4-O2) pairs. Differences in inter- and intra-hemispheric coherence values for the frequency bands between groups were analyzed using the independent t-test. Inter-hemispheric coherence value for the alpha band between Fp1-Fp2 electrodes was significantly lower in MDD+IGD than MDD-only patients. Intra-hemispheric coherence value for the alpha band between P3-O1 electrodes was higher in MDD+IGD than MDD-only patients. Intra-hemispheric coherence values for the beta band between F8-T4, T6-O2, and P4-O2 electrodes were higher in MDD+IGD than MDD-only patients. There appears to be an association between decreased inter-hemispheric connectivity in the frontal region and vulnerability to attention problems in the MDD+IGD group. Increased intra-hemisphere connectivity in the fronto-temporo-parieto-occipital areas may result from excessive online gaming.

Korean Version of Inventory of Complicated Grief Scale: Psychometric Properties in Korean Adolescents.

We aimed to validate the Inventory of Complicated Grief (ICG)-Korean version among 1,138 Korean adolescents, representing a response rate of 57% of 1,997 students. Participants completed a set of questionnaires including demographic variables (age, sex, years of education, experience of grief), the ICG, the Children's Depression Inventory (CDI) and the Lifetime Incidence of Traumatic Events-Child (LITE-C). Exploratory factor analysis was performed to determine whether the ICG items indicated complicated grief in Korean adolescents. The internal consistency of the ICG-Korean version was Cronbach's α=0.87. The test-retest reliability for a randomly selected sample of 314 participants in 2 weeks was r=0.75 (P<0.001). Concurrent validity was assessed using a correlation between the ICG total scores and the CDI total scores (r=0.75, P<0.001). The criterion-related validity based on the comparison of ICG total scores between adolescents without complicated grief (1.2 ± 3.7) and adolescent with complicated grief (3.2 ± 6.6) groups was relatively high (t=5.71, P<0.001). The data acquired from the 1,138 students was acceptable for a factor analysis (Kaiser-Meyer-Olkin Measure of Sampling Adequacy=0.911; Bartlett's Test of Sphericity, χ(2)=13,144.7, P<0.001). After omission of 3 items, the value of Cronbach's α increased from 0.87 for the 19-item ICG-Korean version to 0.93 for the 16-item ICG-Korean version. These results suggest that the ICG is a useful tool in assessing for complicated grief in Korean adolescents. However, the 16-item version of the ICG appeared to be more valid compared to the 19-item version of the ICG. We suggest that the 16-item version of the ICG be used to screen for complicated grief in Korean adolescents.

Differences in Utilization Patterns among Medications in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: a 36-Month Retrospective Study Using the Korean Health Insurance Review and Assessment Claims Database.

We evaluated the differences in utilization patterns including persistence and adherence among medications in children and adolescents with attention deficit hyperactivity disorder (ADHD). The current study was performed using data from the Korean Health Insurance Review and Assessment claims database from January 1, 2009 to December 31, 2013. Our study sample consisted of 10,343 children and adolescents with ADHD who were not given their newly prescribed medication in 360 days before the initial claim in 2010. Data were followed up from the initiation of treatment with ADHD medications in 2010 to December 31, 2013. Discontinuation rates for 4 ADHD medications in our sample ranged from 97.7% for immediate-release methylphenidate to 99.4% for atomoxetine using refill gap more than 30 days and from 56.7% for immediate-release methylphenidate to 62.3% for extended-release methylphenidate using refill gap more than 60 days. In the number of discontinued, we found significant differences among medications using refill gap more than 30 days. Among 4 ADHD medications, extended-release methylphenidate and atomoxetine had more days than immediate-release methylphenidate and osmotic-controlled oral delivery system methylphenidate. In logistic regression analyses, extended-release methylphenidate, osmotic-controlled oral delivery system methylphenidate, and atomoxetine showed less discontinuation compared to immediate-release methylphenidate group when a refill gap more than 30 days was used. In logistic regression analysis of adherence, we could not find any differences among 4 medication types. We suggest that the utilization patterns should be assessed regularly in order to improve future outcomes in children and adolescents with ADHD.

Increasing Relationship Between Negative Emotionality and Conduct Problems During Childhood: A Cross-Sectional Behavioral Genetic Analysis.

Age difference in the etiology of the relationship between childhood negative emotionality (NE) and conduct problems (CP) has not been previously investigated. Mothers of 662 pairs of twins completed questions on the emotionality (NE) scale of the EAS temperament survey and the CP scale of the Strengths and Difficulties Questionnaires (SDQ) via a telephone interview. Twin data were analyzed separately in younger (ages 3 to 7 years; mostly pre-schoolers) and older children (ages 8 to 13 years; mostly elementary school children). The phenotypic correlation between NE and CP increased from 0.33 among younger twins to 0.43 among older twins. Bivariate model-fitting analysis was performed to determine age difference in the etiology of the relationship between NE and CP. Among younger twins, the correlation between NE and CP was entirely explained by additive genetic factors common to NE and CP. Among older children, however, a small but significant amount of unique environmental correlation emerged to account for about 47% of the phenotypic correlation between NE and CP. The remaining 53% of the phenotypic correlation was due to shared additive genetic factors. We speculate that environmental factors associated with school adjustment may exert influences on the relationship between NE and CP among elementary school children.

The Study of Reliability and Validity of the Korean Version of the Trauma Symptom Checklist for Young Children.

The present study aimed to evaluate the psychometric properties of the Korean version of the Trauma Symptom Checklist for Young Children (TSCYC) including reliability and validity. The TSCYC is an instrument to identify trauma symptoms in children from age 3 to 12 yr by their caretakers. The Korean version of the TSCYC was administered to the caretakers of a normative group of 299 children (137 boys and 162 girls) aged 3 to 12 yr and a traumatized group of 73 sexually abused children (22 boys and 51 girls) aged 3 to 12 yr and their caretakers rated the TSCYC and the Child Behavior Checklist and the Child Sexual Behavior Inventory. Among normative group, 88 performed a re-test after 4 weeks. The internal consistency, Cronbach's alpha of total scale of the TSCYC was 0.92 (normative group) and 0.96 (traumatized group). For the nine clinical scales in the TSCYC, it ranged between 0.46-0.92 and 0.77-0.96, respectively. Test-retest correlation of the TSCYC was good (Pearson r score ranging 0.52-0.96). Correlations between the TSCYC and other measures of corresponding constructs were satisfactory. Regarding discriminant validity, the mean total score of the TSCYC was significantly higher in the traumatized children than in the normative group. This study demonstrated that Korean version of the TSCYC is a reliable measure with excellent internal consistency and good stability over 4-week test-retest interval. It can be recommended for clinicians to screen for trauma symptoms after child sexual abuse in Korean young children between the ages 3 and 12.

The Korean Version of the Pediatric Symptom Checklist: Psychometric Properties in Korean School-aged Children.

Psychosocial problems increase the risk for mental health problems and increase the need for health care services in children and adolescents. Primary care practice is a valuable avenue for identifying the need for more specialized mental health care. We hypothesized that Korean version of the pediatric symptom checklist (PSC) would be a useful tool for early detection of psychosocial problems in children and adolescents in Korea and we aimed to suggest cut-off scores for detecting meaningful psychosocial problems. A total of 397 children with their parents and 97 child patients with their parents were asked to complete the PSC Korean version and the child behavior checklist (CBCL). The internal reliability and test-retest reliability of the PSC as well as the cut-off score of the PSC was determined via receiver operating characteristic analysis of the CBCL score, clinical group scores and non-clinical group scores. The internal consistency of the PSC-Korean version was excellent (Cronbach's alpha = 0.95). The test-retest reliability was r = 0.73 (P < 0.001). Using clinical CBCL scores (total score, externalizing score, internalizing score, respectively ≥ 60) and presence of clinical diagnosis, the recommended cut-off score of the PSC was 14. Using 494 Korean children aged 7-12 yr, the current study assessed the reliability and validity of a Korean version of the PSC and suggested a cut-off for recommending further clinical assessment. The present results suggest that the Korean version of the PSC has good internal consistency and validity using the standard of CBCL scores.

No association of the norepinephrine transporter gene (SLC6A2) and cognitive and behavioural phenotypes of patients with autism spectrum disorder.

We examined the association between the norepinephrine transporter (SLC6A2) gene and autism spectrum disorder (ASD) in a Korean population. In addition, we investigated which phenotypes of ASD are best attributed to the genotype of SLC6A2. A total of 184 subjects with ASD, their 156 unaffected siblings and both biological parents were recruited through university hospitals. We used the Autism Diagnostic Interview-Revised, the Aberrant Behaviour Checklist (ABC), the Child Behaviour Checklist (CBCL), the Stroop Colour-Word Interference Test and the Wisconsin Card Sorting Test (WCST) as quantitative measures of the ASD phenotypes. The associations between the quantitative measures and specific single-nucleotide polymorphisms (SNPs) were tested with linear regression analyses. We did not find any evidence of the over-transmission of either allele of the 10SLC6A2 SNPs in the DFAM test. At an empirical p value <0.05, findings that were consistent between the linear regression analyses and the QFAM tests were the positive associations between the A allele of rs36020 and attention problems on the CBCL and stereotypical behaviours on the ABC and between the C allele of rs1814270 and the number of trials required to complete the first WCST category. However, these associations did not remain after correction for multiple testing. The study results of this study do not support the association between the SLC6A2 and the diagnosis or phenotype of ASD. However, the study must be replicated in larger populations and with using more genetic markers.

The Korean version of the trauma symptom checklist for children: psychometric properties and the connection to trauma among Korean children and adolescents.

The purpose of the present study was to develop a Korean version of the trauma symptom checklist for children (TSCC) and to examine its reliability and validity for screening posttraumatic stress symptoms. A normative group of 405 children and adolescents aged 8 to 16 yr participated in the study. A test-retest procedure was conducted with 76 participants from the normative group after 4 weeks. In the traumatized group, 73 children and adolescents of the same age from the Child Sexual Abuse Treatment Center were included. Good internal consistency (Cronbach's alpha) for the total scale (0.95, ranging 0.79-0.85 on the clinical scales) and test-retest reliability for the total scale (r=0.91, ranging 0.71-0.87 on the clinical scales) were found. Confirmatory 6-factor analysis explained 51.1% of the variance. Other measures such as concurrent or discriminative validity were also shown to be satisfactory. In conclusion, the Korean version of TSCC has been shown to be a screening instrument with satisfactory psychometric qualities that is capable of identifying trauma symptoms among children and adolescents who have self-reported experiencing trauma or for whom clinicians have identified traumatic experiences.

Common Comorbid Condition of Patients With Autism Spectrum Disorder and Pharmacotherapy for Patients With Autism Spectrum Disorder.

This article describes common comorbid condtion of the autism spectrum disorder (ASD) and recommends treatment guidelines of pharmacotherapy for patients with ASD. More than 95% of people with ASD have at least one additional disorder and guidelines how to evaluate and treat comorbid conditions in patients with ASD and 7 recommendations for treatment with medication for ASD.