Satisfaction Survey of Telemedicine Services for the Patients With Dementia in the Vulnerable Area for Medical Service / 신경정신의학

Objectives@#To assess the satisfaction of dementia patients with telemedicine services. Underlying factors were extracted from a satisfaction dataset, and possible associations among factors were investigated to determine their statistical relevances. @*Methods@#A survey was conducted using a questionnaire to determine satisfaction with telemedicine services of patients with dementia in 9 public health centers and 5 designated hospitals in 8 provinces in Gangwon-do from 20 July 2020 to 31 October 2020. Four hundred and ninety-seven users responded to the survey. Factor analysis was performed on survey data and multiple linear regression was used to extract relevant factors. @*Results@#The percentage of subjects satisfied with telemedicine services was 78.8%. Thirty-five items of the satisfaction survey indicated that the five factors, that is, necessity (Cronbach’s α 0.952), satisfaction (Cronbach’s α 0.929), medical system reliability (Cronbach’s α 0.924), medical staff reliability (Cronbach’s α 0.924), and geographic vulnerability (Cronbach’s α 0.922), were related to satisfaction with telemedicine services, and that of these, geographic vulnerability was most associated with the need for telemedicine services. @*Conclusion@#This study shows that dementia patients with experience of telemedicine services were generally satisfied with treatment. Despite its limitations, the satisfaction survey was found to provide a reliable and valid scale for assessing user satisfaction.

Comparative analysis of suicide attempt deaths and suicide survivors at one university hospital

Objective@#This study analyzed the characteristics of people who attempted suicide that resulted in deaths as compared to that of the suicide survivors. @*Methods@#This study included 799 suicide attempts that occurred from March 1, 2015, to March 31, 2019 at the emergency department of the university hospital in a city of around 300,000 people. Suicide attempts were classified into the survivor and death groups, and the characteristics of each group were compared. The suicide deaths due to re-attempts were also analyzed. @*Results@#There were more males than females in the death groups. There was a high proportion of people aged 50 or older in the death groups. Hanging, carbon monoxide poisoning, and jumping from great heights were the most commonly used methods of suicide in the death groups. In the selected death group, psychiatric symptom, physical illness, and economic problem among the suicidal causes and depressive disorder among the psychiatric diagnoses were factors that increase the risk of suicide death. Sixty-three point four percent of the survival groups and 52.5% of the selected deaths had not received psychiatric care. On the analysis of suicide deaths due to re-attempts, the average number of suicide attempts was 2.45±0.9. The time from the first suicide attempt to the last suicide attempt was 13.8±10.4 months. @*Conclusion@#If it is necessary to make a treatment decision for a suicide attempt in a limited time, such as the case of treating a suicide attempter who visits an emergency department, it is necessary to consider the characteristic factors of the death attempts of suicidal people.

Survey on the Environment and Condition of Korean Psychiatric Residents from 2016 to 2017 Years / 신경정신의학

OBJECTIVES: The authors evaluated the environment and conditions of Korean psychiatric residents to identify important factors for them in determining their satisfaction with training programs. METHODS: Questionnaires on the residency training program were administered to 513 Korean psychiatric residents from 2016 to 2017. The questionnaire was composed of sociodemographic background, work environment and status of the training program. The authors analyzed questionnaire according to the residents' grade and hospital type and identified the significant factors for satisfaction with their training. RESULTS: Compared to the 1st grade, the 4th grade psychiatric residents have significantly less working time, duty days, and more sleep time, mealtime, and annual salary. In the hospital type, the residents of general hospitals and university hospitals have more working time, annual salary, and accessibility to educational material than mental hospitals. The satisfaction with their training is higher in the 1st grade than in the 4th grade, in those with more than six hours of sleep time, and in residents who are satisfied with the accessibility of educational materials. CONCLUSION: Compared to the 1st grade, the working intensity of 4th grade psychiatric residents is lower and their welfare is better. To improve the satisfaction with the training program, it is necessary to make efforts to increase the sleep time of residents, improve the accessibility of educational material, identify the problem of the training program, particularly in the 4th grade, and make institutional improvements.

Prevalence of Metabolic Syndrome in Patients with Schizophrenia in Korea: A Multicenter Nationwide Cross-Sectional Study

OBJECTIVE: We designed a nationwide study with limited exclusion criteria to investigate the prevalence of metabolic syndrome (MetS) in Korea and its relationship with antipsychotic medications. METHODS: This multicenter, cross-sectional, and observational study included patients diagnosed with schizophrenia or schizoaffective disorder. Sixteen hospitals enrolled 845 patients aged 18 to 65 years prescribed any antipsychotic medication between August 2011 and August 2013. MetS was diagnosed using the criteria of the modified Adult Treatment Panel III of the National Cholesterol Education Program with the Korean abdominal obesity definition (waist circumference ≥85 cm in women, ≥90 cm in men). RESULTS: The prevalence of MetS in all patients was 36.5% and was significantly higher in men than women (men, 40.8%; women, 32.2%) and was significantly correlated with age [odds ratio (OR) 1.02] and duration of illness (OR 1.03). The prevalence of MetS across antipsychotic drugs in the major monotherapy group was as follows: 18.8% for quetiapine, 22.0% for aripiprazole, 33.3% for both amisulpride and paliperidone, 34.0% for olanzapine, 35% for risperidone, 39.4% for haloperidol, and 44.7% for clozapine. CONCLUSION: The prevalence of MetS is very high in patients with schizophrenia or schizoaffective disorder. Screening and monitoring of MetS is also strongly recommended.

Retrospective Recall Study about Psychological and Behavioral Characteristics in High Lethality Suicide Attempters / 신경정신의학

OBJECTIVES: This study was conducted to examine the factors affecting suicide decision and to understand in detail their psychological and behavioral changes with high lethality suicide attempters who were supposed to be similar to suicide completers. METHODS: Twenty patients who visited Kangwon National University Hospital or Chuncheon National Hospital participated in this study. After applying suicide lethality with Risk-Rescue Rating Scale, high lethality attempters were screened. Each subject participated in an in-depth interview with a semi-structured interview schedule. RESULTS: The participants had high mean Risk-Rescue Rating Score (45.0+/-8.7), indicating that the study was conducted with the most lethal suicide attempters. Most attempters had chosen their methods of suicide impulsively without consideration for lethality, and most attempters reported that they chose suicide methods from recall of reports by mass media ; 70% of attempters had more than one previous suicide attempt and their suicide methods have been changed to increase the suicide success rate. Most common accompanying emotions before suicide attempts were hopelessness, helplessness, worthlessness, and loneliness. Most important precipitating factors of suicide were economic difficulties. CONCLUSION: These characteristics regarding suicide attempts led us to a detailed understanding. These results are expected to provide valuable information for development of evidence based suicide prevention policies and strategies.

Investigation of Knowledge, Attitudes, and Experience Regarding Suicidal Behaviors among Psychiatric Residents in Korea : A Cross-Sectional Study / 신경정신의학

OBJECTIVES: This study investigated the effects of the grade of residents, sociodemographic variables, and clinical experience with suicidal patients on the knowledge and attitudes toward suicide among psychiatric residents in Korea. METHODS: A self-reporting survey including 30 questions was conducted together with an investigation of the sociodemographic background of the research subjects. The questionnaire was composed of general knowledge questions on suicide, suicide-related personal experience, attitudes toward suicide, and the treatment experience of suicide attempt patients. Chi-square test and binary logistic regression analysis were used to determine the differences and associations among the attitudes toward suicide, clinical experience of suicide, and sociodemographic characteristics. RESULTS: A significantly higher response rate was presented in the 4th grade on general knowledge of suicide and treatment experience with suicide attempt patients than in the 1st grade. Residents with previous history of psychiatric treatment suicide plans, or attempts presented a significantly higher level of permissive attitude toward suicide. Residents who had a previous history of suicide attempt among their own patients were more likely to think that they were more capable to prevent suicide of patients. CONCLUSION: Effective clinical practices are essential considering the fact that the highest suicide risk groups will inevitably be referred to psychiatric clinical services. The authors expect that the study results regarding suicide-related knowledge, attitudes, and the experience of psychiatric residents will contribute to the development of effective resident training programs for suicide-related clinical practice in Korea.

Physical, Psychological, and Social Risk Factors Affecting Suicidal Ideation among the Elderly / 신경정신의학

OBJECTIVES: The aim of this study is to examine the physical, psychological, and social factors influencing suicidal ideation among elderly Koreans. METHODS: Community Health Survey data obtained in 2013 were used for this study with a sample of 4367 elderly who reside in Gangwon province. The data were analyzed using the chi-square test and the logistic regression test to examine the relationship between suicidal ideation and other variables. RESULTS: Depression was the single most influential variable, both directly and indirectly increasing suicidal ideation. In particular, the increase of suicidal ideation among those with severe disease was affected by depression. Perceived poor social support and perceived poor health status were the two highest risk factors after depression, implying that subjective assessment of the elderly affects suicidal ideation significantly. Poor economic status and current smoking showed significantly higher risk for women only, although poor health, poor social support, and poor social activity commonly attributed to the risk of suicidal ideation in both genders. CONCLUSION: This study suggests that suicidal ideation among the elderly should be approached in a multi-perspective way considering depression, social support, and physical health. It is notable that not only lack of resources but also perceived sense of poor social and physical well-being significantly affect suicidal ideation.

A Preliminary Study of Knowledge, Attitudes, and Experience Regarding Suicidal Behavior among Mental Health Workers in Korea / 신경정신의학

OBJECTIVES: This study was conducted to investigate knowledge, attitude, and experience regarding suicidal behavior among mental health workers in Gangwon province of Korea to use as a basis for development of suicide prevention and education programs. METHODS: Questionnaires consisted of 31 questions including general knowledge regarding suicide statistics and suicide related legislation, attitude toward suicide, awareness of suicide, and individual experiences of suicidal behaviors. Chi-square and binary logistic regression analyses were used to determine differences and association among attitude toward suicide, individual experience of suicide, and sociodemographic characteristics. RESULTS: Taboo attitude toward suicide showed association with age and male. Males thought that social responsibility for suicide is necessary. Religiously non-affiliated group and people who had previous suicidal ideation and attempts showed a more permissive attitude toward suicide. CONCLUSION: The findings of this study suggest that demographic characteristics and previous individual experience of suicidal behaviors might influence attitude toward suicide. These personal characteristics should be considered in development of suicide prevention programs for mental health workers.

A Preliminary Study of Knowledge, Attitudes, and Experience Regarding Suicidal Behavior among Mental Health Workers in Korea / 신경정신의학

OBJECTIVES: This study was conducted to investigate knowledge, attitude, and experience regarding suicidal behavior among mental health workers in Gangwon province of Korea to use as a basis for development of suicide prevention and education programs. METHODS: Questionnaires consisted of 31 questions including general knowledge regarding suicide statistics and suicide related legislation, attitude toward suicide, awareness of suicide, and individual experiences of suicidal behaviors. Chi-square and binary logistic regression analyses were used to determine differences and association among attitude toward suicide, individual experience of suicide, and sociodemographic characteristics. RESULTS: Taboo attitude toward suicide showed association with age and male. Males thought that social responsibility for suicide is necessary. Religiously non-affiliated group and people who had previous suicidal ideation and attempts showed a more permissive attitude toward suicide. CONCLUSION: The findings of this study suggest that demographic characteristics and previous individual experience of suicidal behaviors might influence attitude toward suicide. These personal characteristics should be considered in development of suicide prevention programs for mental health workers.