Social distancing policy and mental health during COVID-19 pandemic: an 18-month longitudinal cohort study in South Korea.

Background: Despite the effectiveness of social distancing policies in preventing the spread of Coronavirus Disease 2019 (COVID-19), their impact on mental health remains a concern. Longitudinal studies investigating the psychological effects of social distancing are limited. Methods: Longitudinal data on psychological variables were collected eight times between May 2020 and November 2021 through online surveys in South Korea. Results: The participants in the study reported a worsening of depressive and anxiety symptoms, suicide risk, and psychological distress with increasing levels of social distancing. Specifically, during the third wave, when social distancing levels peaked, the highest levels of depression, anxiety, and psychological distress were observed, and the second-lowest levels of vitality were reported. Furthermore, psychological risk factors, such as depressive symptoms, anxiety symptoms, and suicidal risk, were closely associated with vitality levels in daily life. Discussions: During the pandemic, although social distancing helped prevent the spread of COVID-19, it also led to increased depression, anxiety, suicide risk, psychological distress, and decreased vitality. Engagement at a personal level in fundamental daily activities is important to cope with psychological distress. Our results indicate that commitment to fundamental daily activities and following routines is an important protective factor against psychological distress, notwithstanding COVID-19.

Defining phenotypes of long-term lithium and valproate response, including combination therapy: a modified application of the Alda scale in patients with bipolar disorders.

BACKGROUND: When evaluating the long-term treatment response to mood stabilizers using the Alda scale, mood stabilizer combination therapy is typically considered a confounding factor, and patients receiving combination therapy are excluded from the analysis. However, this may result in bias if those under combination therapy are worse treatment responders. This study aims to explore whether the Alda scale is applicable to patients taking lithium and valproate combination therapy. We compared long-term treatment response in patients receiving monotherapy and combination therapy of the two drugs, and investigated clinical correlates of the responses to each drug. METHODS: The study subjects consisted of 102 patients with bipolar I (BD-I) or bipolar II (BD-II) disorder who had been undergoing maintenance treatment with lithium and/or valproate for more than 2 years at a single specialized bipolar disorder clinic. Long-term treatment response was measured using the Alda scale and compared among the lithium monotherapy group, the valproate monotherapy group, and the mood stabilizer combination group. Clinical correlates of long-term treatment response were evaluated in lithium users and valproate users separately. RESULTS: There were no significant differences in terms of baseline illness characteristics among groups. The combination group showed the worst treatment response for all the response measurements applied. This group also had the higher rate of 'poor responder' with a statistically significant difference compared to valproate group. Older age at onset and (hypo)manic episode at onset showed significant positive associations with total Alda score in lithium users, while comorbid anxiety disorders, obsessive-compulsive disorder and mixed episode showed significant negative associations in valproate users. CONCLUSIONS: The combination group had poorer long-term treatment response but did not show distinct clinical characteristics compared to the monotherapy groups. When exploring the long-term effects of mood stabilizers, excluding patients undergoing combination treatment could result in bias because they may represent a poor response group. The long-term treatment responses of lithium and valproate had different clinical correlates.

Exploratory Analysis of Behavioral Impulsivity, Pro-inflammatory Cytokines, and Resting-State Frontal EEG Activity Associated With Non-suicidal Self-Injury in Patients With Mood Disorder.

Introduction: Non-suicidal self-injury (NSSI) is a rapidly increasing mental health problem that requires more clinical attention. In this study, we aimed to explore the biobehavioral markers of NSSI in participants with mood disorders. Methods: A total of 45 participants with mood disorders (bipolar I, II, and major depressive disorder) were included in the study. Behavioral impulsivity was measured using the immediate memory task (IMT)/delayed memory task (DMT) and the go-no-go (GNG) tests. Plasma levels of tumor necrosis factor-α (TNF-α), interleukin 1 beta (IL-1 ß), and interleukin 6 (IL-6) and resting-state quantitative electroencephalography (qEEG) were measured. Results: The NSSI group had shorter GNG reaction time (GNG-RT) and higher TNF-α levels compared to the non-NSSI group. TNF-α was positively correlated with frontal theta power. In addition, GNG-RT showed a significant positive association with frontal alpha activity. Conclusion: NSSI in mood disorders was associated with increased behavioral impulsivity and greater inflammation. Increased pro-inflammatory cytokines were associated with frontal theta power. Increased inflammation might change major neurotransmitter metabolism, which eventually affects frontal function and decreases response inhibition. Further studies to explore their causal relationship are warranted.

Current Status of Cognitive Remediation for Psychiatric Disorders: A Review.

Cognition is an important factor that affects daily functioning and quality of life. Impairment in cognitive function is a common symptom present in various psychological disorders, which hinders patients from functioning normally. Given that cognitive impairment has devastating effects, enhancing this in patients should lead to improvements in compromised quality of life and functioning, including vocational functioning. Over the past 50 years, several attempts have been made to improve impaired cognition, and empirical evidence for cognitive remediation (CR) has accumulated that supports its efficacy for treating schizophrenia. More recently, CR has been successfully applied in the treatment of depressive disorders, bipolar disorders, attention deficit/hyperactivity disorder, and anorexia nervosa. This study critically reviews recent CR studies and suggests their future direction. This study aimed to provide a modern definition of CR, and examine the current status of empirical evidence and representative CR programs that are widely used around the world.

The relationship between autobiographical memory, cognition, and emotion in older adults: a review.

Over the past 30 years, the concept of "autobiographical memory" has been highlighted in numerous behavioral and neuroanatomical studies. Importantly, episodic autobiographical memory, an aspect of autobiographical memory, has been shown to decrease with age but can be improved by training. Autobiographical memory is deeply associated with the default mode network (especially posterior cingulate cortex and medial prefrontal cortex), which is particularly interesting in the context of better understanding the relationship between autobiographical memory, cognition, and emotion in older adults. This article provides an overview of the behavioral and neuroanatomical characteristics of autobiographical memory, as well as its relationship with the default mode network, cognition, emotion, and aging. This article also provides an overall review of autobiographical memory training.

The Relationship between Childhood Trauma and Suicidal Ideation: Role of Maltreatment and Potential Mediators.

OBJECTIVE: Childhood trauma is recognized as an important risk factor in suicidal ideation, however it is not fully understood how the different types of childhood maltreatment influence suicidal ideation nor what variables mediate the relationship between childhood trauma and suicidal ideation. This study examined the path from childhood trauma to suicidal ideation, including potential mediators. METHODS: A sample of 211 healthy adults completed the Childhood Trauma Questionnaire (CTQ), Beck scale for Suicidal Ideation (BSI), Functional Social Support Questionnaire (FSSQ) and Hospital Anxiety and Depression Scale (HADS). Path analysis was used to investigate the relationship among study variables. RESULTS: Of the several types of childhood maltreatment we considered, only childhood sexual abuse directly predicted suicidal ideation (ß=0.215, p=0.001). Childhood physical abuse (ß=0.049, 95% confidence interval: 0.011-0.109) and childhood emotional abuse (ß=0.042, 95% confidence interval: 0.001-0.107) indirectly predicted suicidal ideation through their association with anxiety. Childhood neglect indirectly predicted suicidal ideation through association with perceived social support (ß=0.085, 95% confidence interval: 0.041-0.154). CONCLUSION: Our results confirmed that childhood sexual abuse is a strong predictor of suicidal ideation. Perceived social support mediated the relationship between suicidal ideation and neglect. Anxiety fully mediated the relationship between suicidal ideation and both physical abuse and emotional abuse. Interventions to reduce suicidal ideation among survivors of childhood trauma should focus on anxiety symptoms and attempt to increase their social support.

Korean facial emotion recognition tasks for schizophrenia research.

OBJECTIVE: Despite the fact that facial emotion recognition (FER) tasks using Western faces should be applied with caution to non-Western participants or patients, there are few psychometrically sound and validated FER tasks featuring Easterners' facial expressions for emotions. Thus, we aimed to develop and establish the psychometric properties of the Korean Facial Emotion Identification Task (K-FEIT) and the Korean Facial Emotion Discrimination Task (K-FEDT) for individuals with schizophrenia. METHODS: The K-FEIT and K-FEDT were administered to 42 Korean individuals with schizophrenia to evaluate their psychometric properties. To test the convergent and divergent validities, the Social Behavior Sequencing Task (SBST) and hinting task were administered as social-cognitive measures, and the Trail Making Test (TMT)-A and -B were administered as neurocognitive measures. RESULTS: Average accuracy on the K-FEIT and K-FEDT were 63% and 74%, respectively, and internal consistencies of the K-FEIT and K-FEDT were 0.82 and 0.95, respectively. The K-FEIT and K-FEDT were significantly correlated with SBST and Hinting Task, but not with TMT-A and B. CONCLUSION: Following replication studies in a larger sample, the K-FEIT and K-FEDT are expected to facilitate future studies targeting facial emotion recognition in schizophrenia in Korea. Limitations and directions for future research are discussed.

Biological rhythm differences and suicidal ideation in patients with major depressive disorder.

BACKGROUND: Suicidal behavior has been reported to be associated with seasonality and chronotype. However, no study has reported the suicidality according to chronotype and seasonality in patients with major depressive disorder (MDD). This study evaluated the relationship of suicidality and biological rhythm in patients with MDD. METHODS: A total of 120 patients with MDD participated. We evaluated their seasonal patterns, chronotypes (morningness, wake up early and are at their best during the first part of the day; eveningness, feel best and most alert during late hours), suicidal ideations, and other clinical variables including symptom severity. RESULTS: Patients with seasonality showed significantly higher suicidal ideation than patients without seasonality. Compared to morning-type participants, the evening-type participants showed higher suicidality. Suicidal ideation was positively correlated with eveningness tendencies and hypomanic personality traits. LIMITATIONS: First, we did not analyze the causal relationship between biological rhythm and suicidality. Secondly, suicidal ideation does not in most cases reflect an actual attempt. Lastly, we did not categorize seasonal pattern into summer or winter type. CONCLUSIONS: Our findings suggest that biological rhythm is significantly associated with suicidal ideation in patients with MDD.