History of the Task Force for the Korean Clinical Guidelines of the Developmental Disorders.

Under the Ministry of Health and Welfare of the Republic of Korea, the National Autism and Developmental Disorder Centers for people with developmental disabilities are gradually expanding. The headquarters of the National Autism and Developmental Disorder Center provides support for education, training, and research, and several centers have been effectively operating since 2020. This study aimed to provide practical recommendations and guidelines for specialists such as clinical psychologists, child psychiatrists, allied professionals, community workers, and related administrators. It was developed as a guideline to promote early diagnosis, provide important information on integrated treatment, and assist people with developmental disabilities in Korea to make the best decisions for their quality of life.

Sex differences in the factors that affect medical lethality in elderly suicide attempters.

Objectives: This study aimed to identify sex differences in the factors that affect medical lethality in elderly suicide attempters. Methods: A total of 253 elderly suicide attempters and 351 middle-aged attempters (comparison group) who visited the emergency room at a general hospital were included. The sociodemographic and clinical characteristics of the patients were investigated. The Chi-squared test and logistic regression analysis were performed. And Spearman's correlation coefficient was calculated. Results: In older males, the risk of high lethality was lower when attempting suicide due to the loss of family members [adjusted odds ratio (AOR): 0.08]. The risk increased as the intent to die became more certain (some AOR: 11.31, certain AOR: 28.75), and this association became more pronounced with age (rho middle-aged: 0.329; young-old: 0.387; old-old: 0.415). In older females, the risk was lower when employed (AOR: 0.28). The method of suicide attempt also affected lethality (agricultural chemicals AOR: 3.71; psychiatric medication AOR: 0.31). Conclusion: Sex differences in the factors that affect medical lethality were identified among elderly suicide attempters. In particular, medical lethality can be predicted by the degree of suicide intention in older males. These findings will help to establish more efficient preventive strategies with specific targets.

Impact of Parental Mental Health and Help-Seeking on Adolescents' Suicidal Ideations and Help-Seeking Behaviors.

This study aimed to evaluate the impact of parental mental health on adolescent offspring. Data regarding 6512 families from the 2010-2021 Korean National Health and Nutrition Examination Survey were analyzed; among them, 428 were placed in the suicidal ideation (SI) group and 421 were placed in the matched control (MC) group. This number was selected for the use of the propensity score matching method. The findings highlighted significant associations between parental mental health and adolescent suicidal ideation, with mothers in the SI group having higher odds of Diagnosed Depression (OR 2.109, 1.023-4.350 95% CI), Depressive Mood (OR 2.155, 1.224-3.793 95% CI), and Suicidal Ideation (OR 2.532, 1.322-4.851 95% CI) compared to the MC group. Regarding the fathers, paternal Suicidal Ideation (OR 4.295, 1.747-10.599 95% CI) was the only significant factor for adolescent suicidal ideation. In contrast, maternal depressive symptoms and help-seeking behavior significantly impacted adolescent help-seeking; Maternal Depressive Mood increased with adolescent Help-Seeking (OR 4.486, 1.312-15.340 95% CI) while Maternal Suicidal Ideation reduced the probability of Help-Seeking in the SI group (OR 0.15, 0.031-0.721, 95% CI). Chronic and severe depressive symptoms in mothers could make adolescents less likely to seek help for their suicidal ideations. Therefore, clinicians working with adolescents should prioritize a family-oriented approach.

Trajectories of Psychopathology According to Continuation or Discontinuation of Child Abuse: A Longitudinal Observational Study.

Long-term exposure to childhood abuse and occurrence of mental illness are positively correlated. Using long-term tracking data in Korea, we identified the characteristics of children and adolescents who experienced abuse and impact thereof on their psychopathology. Using the Korea Welfare Panel data, 354 teenagers in grades 4-6 of elementary school participated, were assessed at baseline, and monitored 3 years later. They were categorized into Never, Occurrence, Continuation, and Discontinuation groups according to changes in the abuse experienced. Psychopathology was evaluated using K-CBCL. Childhood abuse experience significantly affected psychopathology. At the baseline, the Continuation and Discontinuation groups had a higher severity of psychopathology than the Never group. Psychopathology at the baseline was associated with whether the patient experienced abuse that year. In the follow-up observation, the risk of psychopathology in the Occurrence and Continuation groups was higher than that in the Never group. The Discontinuation group had decreased psychopathology, which was not clinically significant in the follow-up observation (INT aRR = 2.09; 95% CI 0.61-7.13, EXT aRR = 4.23; 95% CI 1.12-16.07). Stopping abuse in late childhood reduces adolescents' psychopathology in the long term, meaning they can recover their normal developmental trajectory according to risk groups and provide effective interventions including discontinuation of abuse.

Does personality problems increase youth suicide risk?: A characteristic analysis study of youth who visit the emergency department following suicide attempt.

BACKGROUND: Youth suicide attempts are a major risk factor for future complete suicides. However, the characteristics of suicide attempters based on the emergency department (ED) have rarely been explored, making it challenging to comprehend the characteristics of youth suicide attempters comprehensively. This study aims to investigate the characteristics of youth suicide attempters who visited the ED. METHODS: We examined the youth (age: 12-25 years) and adult (age: 26-65 years) groups of suicide attempters who visited the ED in Wonju-si, Gangwon-do, Korea. Interviews were conducted with attempters and guardians to identify sociodemographic, clinical, and suicide-related variables. Besides, we performed bivariate logistic regression analysis with statistically adjusted gender, educational age, Socioeconomic Status(SES) level, and medical illness. RESULTS: Youth were diagnosed more frequently with Personality disorder compared to adults. Besides, youth tended to report interpersonal or abuse as motivations for suicide, whereas adults tended to report medical illness or economic problems. Furthermore, youth attempted suicide more impulsively and repeatedly; however, medical lethality of each attempt tended to be lower than adults. LIMITATION: We experienced difficulty in collecting complete information because of poor consciousness or cooperation of patients who visited the ED immediately after suicide attempt. Also, the study cohort was only recruited from one hospital in a region. CONCLUSION: Youth suicide attempters are suggested to have relatively serious and persistent problems involving personality or traits than adults. Thus, this study highlights the significance of preventive strategies based on early psychopathological evaluation and treatment.

Association of Metabolically Healthy Obesity and Future Depression: Using National Health Insurance System Data in Korea from 2009-2017.

(1) Background: The health implications associated with the metabolically healthy obese (MHO) phenotype, in particular related to symptoms of depression, are still not clear. the purpose of this study is to check whether depression and metabolic status are relevant by classifying them into four groups in accordance with the MHO diagnostic standard. Other impressions seen were the differences between sexes and the effects of the MHO on the occurrence of depression. (2) Methods: A sample of 3,586,492 adult individuals from the National Health Insurance Database of Korea was classified into four categories by their metabolic status and body mass index: (1) metabolically healthy non-obese (MHN); (2) metabolically healthy obese (MHO); (3) metabolically unhealthy non-obese (MUN); and (4) metabolically unhealthy obese (MUO). Participants were followed for six to eight years for new incidences of depression. The statistical significance of the general characteristics of the four groups, as well as the mean differences in metabolic syndrome risk factors, was assessed with the use of a one-way analysis of variance (ANOVA). (3) Results: The MHN ratio in women was higher than in men (men 39.3%, women 55.2%). In both men and women, depression incidence was the highest among MUO participants (odds ratio (OR) = 1.01 in men; OR = 1.09 in women). It was concluded as well that, among the risk factors of metabolic syndrome, waist circumference was the most related to depression. Among the four groups, the MUO phenotype was the most related to depression. Furthermore, in women participants, MHO is also related to a higher risk of depressive symptoms. These findings indicate that MHO is not a totally benign condition in relation to depression in women. (4) Conclusion: Therefore, reducing metabolic syndrome and obesity patients in Korea will likely reduce the incidence of depression.

Effectiveness of a Flexible and Continuous Case Management Program for Suicide Attempters.

The purpose of this study was to investigate the effect of continuous case management with a flexible approach on the prevention of suicide by suicide reattempt in a real clinical setting. The subjects in this study were 526 suicide attempters who visited emergency rooms in a teaching hospital in South Korea. Subjects were provided a continuous case management program with a flexible approach according to the severity of their suicide risk and needs. During the entire observation period (from 182 days to 855 days, mean = 572 ± 254), 18 patients (3.7%) died by suicide reattempt: Eight patients (2.27%) in the case management group and 10 patients (7.35%) in the no-case management group. The Cox regression analysis showed that the case management group had a 75% lower risk of death from suicide attempts than the no-case management group (HR = 0.34, 95% CI = 0.13-0.87). This result was shown to be more robust after adjusting for confounding factors such as gender, age, psychiatric treatment, suicide attempts, and family history of suicide (adjusted HR = 0.27, 95% CI = 0.09-0.83). This study was conducted in a single teaching hospital and not a randomized controlled one. A flexible and continuous case management program for suicide attempters is effective for preventing death by suicide reattempts.

Psychological Characteristics and Addiction Propensity According to Content Type of Smartphone Use.

The aim of this study was to evaluate the association between content type of smartphone use and psychological characteristics and addiction propensity, including the average time of smartphone use and problematic smartphone use. Data were obtained from the 2017 Korea Youth Risk Behavior Web-Based Survey, a nationally representative survey of middle- and high-school students (n = 62,276). The content type of smartphone use was divided into four categories: (1) Study, (2) Social-Networking Services (SNS), (3) Game, and (4) Entertainment. The association of depressive mood and suicidal ideation with content type of smartphone use was analyzed, using multiple and binary logistic regression analyses, respectively. The relationship between content type of smartphone use and time spent on smartphone use and problematic smartphone use was analyzed by using multiple logistic regression, adjusted for related covariables. The results of this study revealed that depressive mood and suicidal ideation were significantly associated with the SNS smartphone use group, compared with the other groups. Our results also indicate that the SNS group showed higher addiction propensity, such as overuse and experiencing adverse consequences of smartphone use.

Identifying alcohol problems among suicide attempters visiting the emergency department.

BACKGROUND: Many suicide attempters brought to our emergency department (ED) have been found to have alcohol problems, and this should be taken serious consideration because alcohol use disorder is a risk factor for suicide reattempt. In this study, we aimed to estimate the effectiveness of alcohol-related biochemical markers and Alcohol Use Disorder Identification Test Consumption (AUDIT-C) in suicide attempters who visited our ED based on the gold standard for clinical diagnosis used by psychiatrists for alcohol use disorder. Moreover, we aimed to search for a significant standard when clinicians make correct predictions about alcohol use disorder using these markers. METHODS: Among the subjects who visited ED following a suicide attempt, a total of 203 subjects were selected. Following a psychiatric interview, the subjects who met the criteria for alcohol abuse or alcohol dependence according to DSM-IV-TR in the past year were defined as the "alcohol use disorder" group. Although some subjects did not meet these criteria, men with a weekly alcohol intake of ≥14 drinks and women with a weekly alcohol intake of ≥7 drinks were classified as the "risky drinking" group. AUDIT-C was used as a self-report; further, aspartate aminotransferase, gamma-glutamyltransferase (GGT), and carbohydrate-deficient transferrin (CDT) were assayed using standard methods, and GGT-CDT was calculated using this formula: 0.8 × ln(GGT) + 1.3 × ln(%CDT). RESULTS: In total, 88 subjects met the criteria for alcohol use disorder and 115 were included in the reference group. In the screening for alcohol use disorder, the AUC of AUDIT-C was 0.89 for men and 0.87 for women. In the screening for risky drinking, the AUC of AUDIT-C was 0.99 for men and 0.93 for women. Compared with other biochemical markers, AUDIT-C showed the highest AUC value for screening for both alcohol use disorder and risky drinking, with the trend being more prominent in men. CONCLUSIONS: Among the biochemical markers, AUDIT-C yielded the highest sensitivity, specificity, and accuracy in diagnosing alcohol use disorder among suicide attempters in ED. Comparison of results revealed that the use of AUDIT-C with biochemical markers or its use alone can help screen for alcohol use disorder or risky drinking in clinical settings.

Association between high adolescent smartphone use and academic impairment, conflicts with family members or friends, and suicide attempts.

This study aims to evaluate the association between smartphone use and suicide attempts, independent of possible confounders, including conflicts with family/friends and poor academic performance due to smartphone use. Data were obtained from the 2017 Korea Youth Risk Behavior Web-based Survey, a nationally representative survey of middle- and high-school students (N = 62,276). Time spent using a smartphone was divided into four categories: less than 1 h, 1-2 h, 3-4 h, and 5 h or more a day. The association of conflicts with family due to smartphone use, conflicts with friends due to smartphone use, and poor academic performance due to smartphone use with suicide attempts and time spent using a smartphone were analyzed using multiple and binary logistic regression analyses, respectively. The relationship between time spent on a smartphone and suicide attempts was analyzed using a multiple logistic regression analysis. All analyses were also stratified according to the main purpose of smartphone use (process purposes/social purposes). Conflicts with family/friends due to smartphone use was significantly associated with suicide attempts (P <0.001). The variables of conflicts with family, conflicts with friends and poor academic performance were also proportionally related to higher smartphone use (P <0.001). The use of a smartphone was significantly associated with suicide attempts in a multiple logistic regression analysis (adjusted odds ratio for smartphone use 5 h or more a day 2.16; 95% CI 2.07-2.26; P <0.001), and the association was more prominent with smartphone use for process purposes. Conflicts with family, conflicts with friends, poor academic performance, and suicide attempts were related to higher smartphone use in Korean adolescents. Time spent on a smartphone was positively related to suicide attempts, even after adjusting for conflicts with family members or friends and poor academic performance due to smartphone use.

Characteristics of adolescents who visit the emergency department following suicide attempts: comparison study between adolescents and adults.

BACKGROUND: The purpose of this study was to identify the demographic and clinical characteristics of suicide attempts in adolescents who visit the emergency department compared to those of adults. METHODS: This study included 149 children under the age of 18, and 1427 people in the age of 19-65 who came to the emergency department with suicide attempt from 2009 to 2015. We compare sociodemographic, clinical, and suicide attempt-related characteristics through Chi-square test and logistic regression analysis to evaluate the difference between two groups. RESULTS: In adolescents, suicide attempters had more number of previous suicide attempt history than adults. Adolescents used more non-lethal method such as poisoning of over the counter drugs and had about 5 times higher odds ratio in suicide attempts with analgesics. The motivation of suicide attempt among adolescents was more related with interpersonal problems but less with financial or illness-related problems. The intention of suicide attempt in adolescents was less serious and lethal compared to adults. CONCLUSION: Suicide attempts among adolescents had showed different from adults in method, motivation and intention. Considering the characteristics of suicide attempt among adolescent, it is necessary to keep close attention to adolescent's suicide attempters and develop the customized intervention program to prevent the suicide attempt in this groups.

Prolonged Risk of Suicide Reattempts in Patients with Alcohol Use Disorder and Acute Alcohol Use: A Register-Based Follow-Up Study (2010-2015).

OBJECTIVE: This study aimed to clarify the role of acute alcohol use and alcohol use disorder in individuals exhibiting suicidal behaviors, including repetition of suicide attempt. METHODS: Data pertaining to 691 suicide attempters who had visited an emergency center and had been followed-up from 2010 to 2015 were gathered. Participants were categorized into following three groups according to alcohol use pattern at the time of the suicide attempt: 1) suicide attempters with neither alcohol use disorder nor acute alcohol consumption (NAU), 2) suicide attempters who had used alcohol during the suicide attempt but did not have alcohol use disorder (AAU), and 3) suicide attempters with alcohol use disorder (AUD). Group comparisons and multivariate Cox proportional models for suicidal behavior were used for statistical analysis. RESULTS: AUD have been shown to have lower lethality of suicide attempt but higher risk of suicide reattempts in the future. Furthermore, positive relationships between suicide reattempts and AUD persisted throughout the longer period than other groups. CONCLUSION: Suicide attempters with AUD should be considered a high-risk group for suicide reattempts in future, and this group should be followed-up for a longer period with specialized care program.

Depressive symptoms and suicidal behaviours in adolescent non-daily smokers compared to daily smokers and never-smokers in Korea: National cross-sectional study.

INTRODUCTION: We aimed to investigate the association of non-daily smoking with depressive symptoms and suicidal behaviours among adolescents by analysing data from the 2016 Korean Youth Risk Behavior Web-based Survey (KYRBWS), a national school-based survey. METHODS: We analysed data from a nationally representative sample of Korean adolescents aged 12-18 years (n = 65,528). We investigated the risks of depressive symptoms, suicide ideation, plan and attempt in adolescent non-daily smokers using multiple logistic regression analyses after adjusting for confounding factors. Taking into account the trajectory of smoking patterns in adolescents, we assessed all analyses with stratification by early (aged 12-15) and late (aged 16-18) adolescents. RESULTS: Among early adolescents, non-daily smokers were more likely to have depressive symptoms, suicide ideation and plan compared with never smokers and even more likely to have depressive symptoms compared with daily smokers. Among late adolescents, non-daily smokers had higher risks of depressive symptoms, suicide ideation, plan and attempt than never smokers, whereas the risk for suicide attempts was lower than daily smokers. CONCLUSIONS: Our findings suggest that non-daily smoking in adolescents was associated with risks for depressive symptoms and suicidal behaviours, and the association was more prominent in early adolescents. Careful attention on the mental health of adolescent non-daily smokers is needed because this is an increasing and easily overlooked group.

Sociodemographic and clinical characteristics of old-old suicide attempters compared with young-old and middle-aged attempters.

OBJECTIVES: The purpose of this study was to identify distinctive characteristics of old-old suicide attempters (75 years and older) from young-old (60-74 years old) and middle-aged suicide attempters (45-59 years old). METHODS: We included consecutive series of 920 patients aged 45 years and older who had visited the emergency room from 2009 to 2015 because of suicide attempts. They were divided into 3 groups according to age. Information about the suicide attempt and sociodemographic status was gathered through interviews with attempters or caregivers. Chi-square test and logistic regression analysis were performed to evaluate the differences among the 3 groups. RESULTS: We found that old-old suicide attempters had high intent to die and high medical lethality as a result of the attempt, and illness-related problems exerted a strong motivational effect on this group. Psychiatric drugs, pesticides, and herbicides were frequently used to attempt suicide. These attempts were less likely to be associated with alcohol consumption compared to other age groups. CONCLUSION: Old-old suicide attempters have different characteristics, compared with young-old and middle-aged counterparts. It is necessary to assess suicide risk and depression when examining patients with physical illness or when prescribing psychotropic drugs. High-risk groups should be given immediate intervention including psychiatric treatment before they act on high suicide intent.

Impact of psychotic symptoms on clinical outcomes in delirium.

Delirium is an acute disturbance in attention and awareness in response to one or more physiological stressors that is closely related to poor clinical outcomes. The aim of this study is to investigate whether delirium patients with psychotic symptoms (PS) would have unique clinical characteristics and outcomes. A retrospective chart review was performed on the patients with delirium due to general medical conditions to assess clinical characteristics and outcomes. All patients were assessed by Delirium Rating Scale-revised-98 and classified as having PS when scored two or more on at least one of the psychotic symptom items (perceptual disturbances, delusions, and thought process abnormalities). Of 233 patients with delirium, 116 (49.8%) manifested PS. Patients with PS were younger, more likely to use antipsychotics to manage delirium, and had more hyperactive motor subtype than patients without PS. Logistic regression analysis showed that odds ratio of psychotic symptoms for having in-hospital mortality was 0.27 (95% CI = 0.08-0.94) after controlling age, sex, disease severity, comorbidity, number of medications, etiologies, motor subtypes, delirium severity and use of antipsychotics. The present study demonstrated that PS of delirium was associated with unique clinical characteristics and may affect the clinical course in a psychiatry-referral sample.

Psychological Stress Deteriorates Skin Barrier Function by Activating 11ß-Hydroxysteroid Dehydrogenase 1 and the HPA Axis.

Psychological stress (PS) increases endogenous glucocorticoids (GC) by activating the hypothalamic-pituitary-adrenal axis. The negative effects of GC on skin barrier function under PS have been well-established. However, endogenous GC can also be active when cortisone (inactive form) is converted to cortisol (active form) by 11ß-hydroxysteroid dehydrogenase type I (11ß-HSD1) in the peripheral tissue. Here, we evaluated the changes in 11ß-HSD1 and barrier function under PS. Elevated 11ß-HSD1 in oral mucosa correlated with increased cortisol in the stratum corneum and deteriorated barrier function. Expression of 11ß-HSD1 in the oral mucosa correlated with that in the epidermal keratinocytes. We further investigated whether barrier function improved when PS was relieved using a selective serotonin reuptake inhibitor (SSRI) in patients with anxiety. Decreased 11ß-HSD1 and improved barrier function were observed after SSRI treatment. The collective findings suggest that elevated 11ß-HSD1 under PS increases the level of cutaneous GC and eventually impairs barrier function. PS-alleviating drugs, such as SSRI, may help to treat PS-aggravated skin diseases.

The Role of Uncontrolled Eating and Screen Time in the Link of Attention Deficit Hyperactivity Disorder with Weight in Late Childhood.

OBJECTIVE: The aim of this study was to examine the mediating roles of uncontrolled eating and sedentary behaviours in the link of attention deficit hyperactivity disorder (ADHD) and weight. METHODS: A total of 352 children in fifth and sixth grade participated in the present study by completing the self-rated Three-Factor Eating Questionnaire and Children of Alcoholics Screening Test during regular classes. An additional questionnaire completed by their parents provided information about the children's ADHD and emotional symptoms, sedentary behaviour based on screen time, and parental variables. The questionnaires were surveyed within one week after their schools' annual physical check-up. RESULTS: Hierarchical regression analyses revealed that uncontrolled eating was complete mediator in association between ADHD symptoms and body mass index (BMI) for boys, incomplete mediator for girls. However, screen time had no significant effect on the ADHD symptoms-BMI link for both gender. CONCLUSION: The findings of this study suggest that gender specific intervention programs may be need to help eating behaviour in children with ADHD and overweight.

Psychometric Properties of the Self-Report Version of the Strengths and Difficulties Questionnaire in Korea.

OBJECTIVE: To examine the reliability and validity of the self-report Korean version of Strengths and Difficulties Questionnaire (SDQ-Kr) in the community sample. METHODS: The SDQ-Kr was administered to a large sample of school children and adolescents (n=2814) and youth attendees of a psychiatric clinic (n=385) aged 11-16 years. To examine temporal stability, the same questionnaire was administered to a subsample of 167 school youths five to six weeks after the initial assessment. To examine the reliability, we calculated Cronbach's alpha coefficients for internal consistency and Pearson's correlations for test-retest stability. In order to evaluate the factorial structure of the SDQ-Kr items, we conducted an exploratory factor analysis (EFA) with varimax rotation. Finally, discriminant validity was examined by using receiver operating characteristic (ROC) curves employing the area under the curve (AUC) as an index of discriminant ability. RESULTS: Although the internal consistency of some subscales of the SDQ-Kr was somewhat less satisfactory (alpha coefficients; 0.28-0.54) than the English original, coefficients for the total difficulties scores approached sufficient levels (coefficients; 0.69). Other psychometric properties including discriminant validity (AUC for total difficulties and four subscales >0.7) were comparable to those obtained in other language studies. CONCLUSION: The self-report SDQ-Kr exhibited a low level of reliability, indicating that some items need to be further evaluated and revised to improve the psychometric properties. We suggest that the total difficulties score could be used with more confidence for screening possible mental health problems in youths.

Extending a structural model of somatization to South Koreans: Cultural values, somatization tendency, and the presentation of depressive symptoms.

BACKGROUND: Somatization refers to the tendency to emphasize somatic symptoms when experiencing a psychiatric disturbance. This tendency has been widely reported in patients from East Asian cultural contexts suffering from depression. Recent research in two Chinese samples have demonstrated that the local cultural script for depression, involving two aspects-the experience and expression of distress (EED) and conceptualization and communication of distress (CCD)-can be evoked to help explain somatization. Given the beliefs and practices broadly shared across Chinese and South Korean cultural contexts, the current study seeks to replicate this explanatory model in South Koreans. METHODS: Our sample included 209 psychiatric outpatients from Seoul and Wonju, South Korea. Self-report questionnaires were used to assess somatization tendency, adherence to traditional values, and psychological and somatic symptoms of depression. RESULTS: Results from SEM showed that the EED and CCD factors of somatization tendency were differently associated with cultural values and somatic symptoms, replicating our previous findings in Chinese outpatients. LIMITATIONS: The reliance on a brief self-report measure of somatization tendency, not originally designed to assess separate EED and CCD factors, highlights the need for measurement tools for the assessment of cultural scripts in cross-cultural depression research. CONCLUSIONS: The replication of the Chinese structural model of somatization in South Korea lends empirical support to the view that somatization can be understood as the consequence of specific cultural scripts. These scripts involve the experience and expression of distress as well as culturally meaningful ways in which this distress is conceptualized and communicated to others.

Alcohol dependence, mortality, and chronic health conditions in a rural population in Korea.

To determine the effects of excessive drinking and alcohol dependency on mortality and chronic health problems in a rural community in South Korea, this study represents a nested case-control study. In 1998, we conducted the Alcohol Dependence Survey (ADS), a population survey of a village in Korea. To measure the effects of alcohol on chronic health conditions and mortality over time, in 2004, we identified 290 adults from the ADS sample (N=1,058) for follow-up. Of those selected, 145 were adults who had alcohol problems, either alcohol dependence as assessed in the ADS by the Severity of Alcohol Dependence Questionnaire (N=59), or excessive drinking without dependency (N=86). Further 145 nondrinkers were identified, matching those with alcohol problems in age and sex. We revisited the village in 2004 and completed personal interviews with them. In multivariate logistic regressions, the rates of mortality and morbidity of chronic health conditions were three times greater for alcohol dependents compared with the rate for nondrinkers. Importantly, however, excessive drinking without dependency was not associated with the rates of either mortality or morbidity. Future investigations would benefit by attending more specifically to measures for alcohol dependence as well as measures for alcohol consumption.