Proteomic profiling in the progression of psychosis: Analysis of clinical high-risk, first episode psychosis, and healthy controls.

BACKGROUND AND HYPOTHESIS: Recent evidence has highlighted the benefits of early detection and treatment for better clinical outcomes in patients with psychosis. Biological markers of the disease have become a focal point of research. This study aimed to identify protein markers detectable in the early stages of psychosis and indicators of progression by comparing them with those of healthy controls (HC) and first episode psychosis (FEP). STUDY DESIGN: The participants comprised 28 patients in the clinical high-risk (CHR) group, 49 patients with FEP, and 61 HCs aged 15-35 years. Blood samples were collected and analyzed using multiple reaction monitoring-mass spectrometry to measure the expression of 158 peptide targets. Data were adjusted for age, sex, and use of psychotropic drugs. STUDY RESULTS: A total of 18 peptides (17 proteins) differed significantly among the groups. The protein PRDX2 was higher in the FEP group than in the CHR and HC groups and showed increased expression according to disease progression. The levels of six proteins were significantly higher in the FEP group than in the CHR group. Nine proteins differed significantly in the CHR group compared to the other groups. Sixteen proteins were significantly correlated with symptom severity. These proteins are primarily related to the coagulation cascade, inflammatory response, brain structure, and synaptic plasticity. CONCLUSIONS: Our findings suggested that peripheral protein markers reflect disease progression in patients with psychosis. Further longitudinal research is needed to confirm these findings and to identify the specific roles of these markers in the pathogenesis of schizophrenia.

Standardized Suicide Prevention Program for Gatekeeper Intervention of North Korean Defectors in South Korea.

OBJECTIVE: North Korean defectors (NKDs) have experienced substantial difficulties during the migration and settlement in South Korea. They have a high prevalence of depression, post-traumatic stress disorder, and suicidal behaviors. The high prevalence of mental disorders among NKDs can lead to a high suicide rate. However, there are no suicide prevention programs for NKDs. This study aims to customize a suicide prevention program with content suitable for NKDs' particular circumstances. METHODS: A multidisciplinary research team developed this program based on domestic and international gatekeeper training programs for suicide prevention and articles related to suicide prevention. RESULTS: We developed a multi-part gatekeeper training program, "Suicide CARE for NKDs." In the "Introduction," trainees learn about the need for the program and its importance. In "Careful observation," trainees learn to recognize linguistic, behavioral, and situational signals of suicide risk. In "Active listening," trainees learn how to ask about suicidal thoughts and to listen empathetically. In "Risk evaluation and expert referral," trainees learn to evaluate suicide risk and to connect NKDs with institutes or services. CONCLUSION: We expect this program to become useful for training gatekeepers to prevent suicide among NKD. A future follow-up study is needed to confirm the efficacy of the program.

Alterations in blood proteins in the prodromal stage of bipolar II disorders.

Although early intervention may help prevent the progression of bipolar disorder, there are some controversies over early pharmacological intervention. In this study, we recruited 40 subjects in the prodromal stage of BD-II (BP), according to bipolar at-risk state criteria. We compared the expression of their plasma proteins with that of 48 BD-II and 75 healthy control (HC) to identify markers that could be detected in a high-risk state. The multiple reaction monitoring method was used to measure target peptide levels with high accuracy. A total of 26 significant peptides were identified through analysis of variance with multiple comparisons, of which 19 were differentially expressed in the BP group when compared to the BD-II and HC groups. Two proteins were overexpressed in the BP group; and were related to pro-inflammation and impaired neurotransmission. The other under-expressed peptides in the BP group were related to blood coagulation, immune reactions, lipid metabolism, and the synaptic plasticity. In this study, significant markers observed in the BP group have been reported in patients with psychiatric disorders. Overall, the results suggest that the pathophysiological changes included in BD-II had already occurred with BP, thus justifying early pharmacological treatment to prevent disease progression.

Contents of the Standardized Suicide Prevention Program for Gatekeeper Intervention in Korea, Version 2.0.

OBJECTIVE: Suicide is a huge nationwide problem that incurs a lot of socio-economic costs. Suicide also inflicts severe distress on the people left behind. The government of the Republic of Korea has been making many policy efforts to reduce suicide rate. The gatekeeper program, 'Suicide CARE', is one of the meaningful modalities for preventing suicide. METHODS: Multidisciplinary research team collaborated to update the 'Suicide CARE' to version 2.0. RESULTS: In the 'Introductory part', the authors have the time to think about the necessity and significance of the program before conducting full-scale gatekeeper training. In the 'Careful observation' part, trainees learn how to understand and recognize the various linguistic, behavioral, and situational signals that a person shows before committing suicide. In the 'Active listening' part, trainees learn how to ask suicide with a value-neutral attitude as well listening empathetically. In the 'Risk evaluation and Expert referral' part, trainees learn intervening strategies to identify a person's suicidal intention, plan, and past suicide attempts, and connect the person to appropriate institutes or services. CONCLUSION: Subsequent studies should be conducted to verify the efficacy of the gatekeeper program.

"Suicide CARE" (Standardized Suicide Prevention Program for Gatekeeper Intervention in Korea): An Update.

OBJECTIVE: In 2011, "Suicide CARE" (Standardized Suicide Prevention Program for Gatekeeper Intervention in Korea) was originally developed for the early detection of warning signs of suicide completion, since there is a tendency to regard emotional suppression as a virtue of Korean traditional culture. A total of 1.2 million individuals completed the training program of "Suicide CARE" in Korea. METHODS: More sophisticated suicide prevention approaches according to age, sex, and occupation have been proposed, demanding for a more detailed revision of "Suicide CARE." Thus, during the period from August 2019 to February 2020, "Suicide CARE" has been updated to version 2.0. The assessments on domestic gatekeeper training programs for suicide prevention, international gatekeeper training programs for suicide prevention, psychological autopsy interview reports between 2015 and 2018, and the evaluation of feedback from people who completed "Suicide CARE" version 1.6 training were performed. RESULTS: We describe the revision process of "Suicide CARE," revealing that "Suicide CARE" version 2.0 has been developed using an evidence-based methodology. CONCLUSION: It is expected that "Suicide CARE" version 2.0 be positioned as the basic framework for many developing gatekeeper training programs for suicide prevention in Korea in the near future.

Prevalence and comorbidities of adult adhd in male military conscripts in korea: Results of an epidemiological survey of mental health in korean military service.

We assessed the prevalence/comorbidities of attention deficit hyperactivity disorder (ADHD) in Korean servicemen using the Epidemiological Survey of Mental Health in Military Service in Korea. A total of 3,441 participants were assessed for adult ADHD, depression, social anxiety, generalized anxiety, somatization, insomnia, suicidality, cigarette dependence, and alcohol dependence using a self-report scale. Participants were also asked to rank their perception of their career prospects, health status, and quality of life on a Likert scale. Participants were classified as ADHD according to the WHO A-ADHD self-report scale. Firth multiple logistic regression and Cochran-Armitage trend tests were used to identify the risks of comorbidities and trends of self-perception between the two groups. ADHD (prevalence: 2.8%) was significantly associated with social anxiety (OR, 40.52; 95% CI 25.14-65.74), generalized anxiety (OR, 28.21; 95% CI 17.37-45.69), depression (OR, 16.36; 95% CI 10.50-25.52), somatization (OR, 14.47; 95% CI 9.21-22.76), suicidality (OR, 11.03; 95% CI 6.67-17.86), and insomnia (OR, 5.92; 95% CI 3.68-9.35). Servicemen with ADHD had negative perceptions (p <0.001) of their career prospects, health status, and quality of life compared to servicemen without ADHD. It is essential to revise the enlistment criteria for individuals with ADHD or to develop management programs for servicemen with ADHD.

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.

Somatic symptoms and sleep quality as indicators of depression and suicide risk among Korean military conscripts.

This study examined whether somatic symptoms and sleep quality can be indicators of depression and suicide risk in Korean military conscripts. In October and November of 2016, a total of 1,937 conscripts completed a survey that included the patient health questionnaire (PHQ) 9, PHQ15, the Mini International Neuropsychiatric Interview Plus suicidality module, and the Pittsburgh sleep quality index. Four groups were formed by depression and suicide risk status. Results from analyses of covariance indicated that overall, the severity of somatic symptoms and aspects of sleep quality were higher in conscripts with both depression and suicide risk, and greater associations of depression with somatic symptoms and sleep quality. The results of logistic regression analyses indicated that moderate to high levels of somatic symptoms and poorly perceived health were associated with the risk of depression and suicide, respectively. Poor sleep quality was associated with a higher risk of depression, but it was not significantly related to suicide risk after accounting for depression, which showed a greater association with suicide risk. Monitoring somatic and sleep complaints along with perceived health are needed as potential markers of depression and suicide risk among military conscripts.