The Experiences of Health Care Workers during the COVID-19 Pandemic in Korea: a Qualitative Study.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, health care workers (HCWs) have faced multiple physical and psychological challenges while carrying out their duties. In this study, we examined the experiences of specific groups of HCWs during the pandemic. METHODS: From 18 November to 30 December 2020, we conducted a qualitative study using semi-structured, face-to-face interviews with four groups of 14 HCWs in three cities (Seoul, Daegu, and Gwangju) in South Korea. The HCWs who participated in the focus groups included physicians, nurses, medical practitioners, and cleaning staff who directly or indirectly cared for patients during the COVID-19 epidemic. Interviews were transcribed verbatim and analyzed using the consensual qualitative research approach. RESULTS: Our qualitative data analysis revealed four main domains: work-related struggles, personal life-related struggles, psychological stress, and health-related struggles. Health care providers were challenged by working in critical situations and were overwhelmed by heavy workloads, fear of infection, lifestyle changes, and psychological and physical struggles. CONCLUSION: Our findings could serve as a foundation for establishing health care systems and policies that help HCWs cope with occupational stress, thus increasing their ability to adapt to the ongoing COVID-19 pandemic.

The Role of N-Glycosylation in the Intracellular Trafficking and Functionality of Neuronal Growth Regulator 1.

Neuronal growth regulator 1 (NEGR1) is a brain-enriched membrane protein that is involved in neural cell communication and synapse formation. Accumulating evidence indicates that NEGR1 is a generic risk factor for various psychiatric diseases including autism and depression. Endoglycosidase digestion of single NEGR1 mutants revealed that the wild type NEGR1 has six putative N-glycosylation sites partly organized in a Golgi-dependent manner. To understand the role of each putative N-glycan residue, we generated a series of multi-site mutants (2MT-6MT) with additive mutations. Cell surface staining and biotinylation revealed that NEGR1 mutants 1MT to 4MT were localized on the cell surface at different levels, whereas 5MT and 6MT were retained in the endoplasmic reticulum to form highly stable multimer complexes. This indicated 5MT and 6MT are less likely to fold correctly. Furthermore, the removal of two N-terminal sites N75 and N155 was sufficient to completely abrogate membrane targeting. An in vivo binding assay using the soluble NEGR1 protein demonstrated that glycans N286, N294 and N307 on the C-terminal immunoglobulin-like domain play important roles in homophilic interactions. Taken together, these results suggest that the N-glycan moieties of NEGR1 are closely involved in the folding, trafficking, and homodimer formation of NEGR1 protein in a site-specific manner.

Difficulties of healthcare workers encountered under cohort isolation in a psychiatric hospital during the COVID-19 pandemic: A qualitative study.

This study examined the experiences of healthcare workers who were quarantined within the psychiatric wards due to COVID-19 and analyzed those experiences with a consensual qualitative research method. Participants experienced (a) difficulties due to the specificity of a mental hospital, including a lack of protocols, noncompliance with quarantine guidelines among patients with severe mental illness, and a shortage of institutions capable of containing confirmed COVID-19 patients with severe mental illness. Furthermore, (b) difficulties related to isolation of the cohort itself included a workforce shortage, physical problems, fear of infection, limited facilities, guilt toward newly confirmed cases, exhaustion, and distress caused by separation from family. The participants also described (c) difficulties related to external factors, including administrative orders and the perceived stigma, and (d) positive experiences. Appropriate support is needed during the COVID-19 pandemic to reduce the difficulties among healthcare workers in psychiatric hospitals. This includes preparation for future scenarios, facilities, and workers in response to outbreaks of infection in psychiatric hospitals that cause unique risks and challenges among those workers.

Predictors of the Development of Mental Disorders in Hospitalized COVID-19 Patients without Previous Psychiatric History: A Single-Center Retrospective Study in South Korea.

The objective of this study was to investigate the predictors for new-onset mental disorders among patients with mild to moderate COVID-19 illness during hospitalization. A retrospective cohort study was performed in patients with confirmed COVID-19 admitted to a nationally designated hospital between 1 February and 30 June 2020. Demographic, clinical, psychological assessments, and psychiatric outcomes were obtained from electronic medical record review. Multivariate logistic regression analysis was used to identify predictors of new-onset mental disorders. Among 185 patients, 130 had no history of mental disorders or cognitive impairment at the time of admission. Of 130 patients, 29 (22.3%) were newly diagnosed with mental disorders during hospitalization. The following factors were significantly associated with an increased risk of a psychiatric diagnosis: Charlson comorbidity index core ≥1 (adjusted odds ratio (aOR) = 5.115, 95% confidence interval (CI): 1.737-15.058), length of stay (aOR per 1-day increase = 1.067, 95% CI: 1.035-1.100), and self-reported depressive symptoms at the time of admission (aOR = 5.357, 95% CI: 1.745-16.444). The predictive accuracy of combining these risk factors was relatively high (area under curve = 0.851, 95% CI: 0.778-0.923). These potential risk factors could help to predict the new-onset mental disorder among hospitalized patients with COVID-19.

Validation of the Korean Version of the Psychosis Screener to Identify Patients With Psychosis.

OBJECTIVE: This study aimed to validate the Korean version of a short screening tool for psychosis as the first stage in finding undiagnosed psychosis in the community. METHODS: The sample contained 126 consecutive psychiatric outpatients in National Medical Center, Seoul, Korea, between July 20 and July 22, 2020. The Psychosis Screener (PS) comprises 7 items covering psychotic symptoms. The presence of each psychotic symptom was determined by a trained mental health professional and coded "yes" or "no." Two psychiatrists reviewed the medical records independently and extracted the ICD-10-based diagnoses. Any differences between the two clinicians were resolved by consensus, and the agreed diagnosis was used as a gold standard in the study. RESULTS: Among 126 psychiatric outpatients who were enrolled in a consecutive manner during the study period, the proportion of psychosis was 15.1%. The PS showed 78.9% sensitivity and 72.0% specificity when the optimal cut-off was 2, indicating that a score of 2 or more on the screener identified a likely case of psychosis. The area under the curve for the PS was 0.78 (95% CI: 0.67-0.87). CONCLUSION: The Korean version of the PS has an ability to discriminate between those who meet the diagnostic criteria for psychosis and those who do not in a high-prevalence group.