OBJECTIVE:This study estimated the prevalence of problematic smartphone use (PSU) among multicultural adolescents and examined its association with major mental health indicators. METHODS:We conducted a cross-sectional analysis of the 2020 Korea Youth Risk Behavior Web-based Survey, which included 1,065 adolescents from multicultural families. PSU was assessed via the validated Korean version of the Smartphone Overdependence Scale. The mental health variables included perceived stress, loneliness, anxiety symptoms, and suicidal ideation, plans, and attempts. Multivariate logistic regression models were used to identify factors associated with PSU. Structural equation modeling (SEM) was applied to evaluate the direct associations between PSU and mental health outcomes and to test the moderating effects of key demographic and psychosocial factors. RESULTS:The prevalence of PSU among multicultural adolescents was 26.2%. Compared with adolescents not in the PSU group, those in the PSU group more frequently reported high perceived stress, frequent loneliness, elevated anxiety symptoms, and suicidal ideation. In adjusted models, PSU was independently associated with higher odds of stress, loneliness, anxiety, and suicidal planning, as well as lower academic achievement. The SEM findings supported significant associations between PSU and multiple mental health indicators, with some associations being stronger among girls, adolescents from lower-income households, and those experiencing higher levels of stress or loneliness. CONCLUSION:Among Korean multicultural adolescents, PSU is common and is associated with multiple adverse mental health and poorer academic self-perceptions. These findings underscore the importance of culturally sensitive strategies that address both digital media use and psychosocial well-being among multicultural adolescents.
OBJECTIVE:Psychotic symptoms are common in Parkinson's disease (PD), yet it remains unclear whether these manifestations reflect transient, medication-related phenomena or an increased risk of clinically diagnosed schizophrenia spectrum disorders (SSD). This study aimed to evaluate the long-term risk of incident SSD following PD using a nationwide population-based cohort and to assess whether this risk varies across demographic, lifestyle, and metabolic subgroups. METHODS:We conducted a retrospective cohort study using the Korean National Health Insurance Service database from 2012 to 2023. Individuals newly diagnosed with PD were identified using repeated International Classification of Diseases, 10th Revision (ICD-10) codes and matched 1:5 with controls using propensity scores. Incident SSD was defined by repeated ICD-10 diagnoses. Incidence rates, incidence rate ratios, Kaplan-Meier curves, and Cox proportional hazards models were used. RESULTS:Among 5,110 patients with PD and 25,550 matched controls, 128 and 177 incident cases of SSD were identified, respectively. The incidence rate of SSD was higher in the PD group than in controls (7.09 vs. 1.75 per 1,000 person-years), yielding an IRR of 4.06 (95% confidence interval [CI], 3.23-5.09). PD was associated with an increased risk of SSD after multivariable adjustment (adjusted hazard ratio 4.90; 95% CI, 3.52-6.81), with particularly elevated risk among individuals younger than 60 years. CONCLUSION:PD was associated with a substantially increased long-term risk of SSD. These findings suggest that psychotic manifestations following PD may reflect persistent psychiatric morbidity rather than transient symptoms alone.
Objective This study aimed to develop and validate a trauma checklist specifically designed to capture the complex and culturally unique potentially traumatic events (PTEs) experienced by North Korean defectors (NKDs), in alignment with International Classification of Diseases, 11th Revision criteria that distinguish posttraumatic stress disorder (PTSD) from complex PTSD (cPTSD).Methods A cross-sectional secondary data analysis was conducted using online survey data from 520 NKDs. Participants were randomly divided into two groups (n=260 each) for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). A preliminary 22-item PTE checklist was refined through factor analysis and reliability testing. Criterion validity was assessed using the Depression and Somatic Symptom Scale and World Health Organization of Life Assessment Instrument Bref. Statistical analyses were performed using SPSS 28.0 and AMOS 28.0.Results EFA identified a four-factor model: “death and life-threatening events,” “interpersonal violence and discrimination,” “violence by public authorities,” and “family dissolution”—comprising 17 refined items. CFA confirmed a good model fit (RMSEA=0.059, GFI=0.930, CFI=0.930). Internal consistency for the total scale was high (Cronbach’s α=0.830), with acceptable reliability across most subscales. The checklist demonstrated strong criterion validity with depression, somatic symptoms, and quality of life indices.Conclusion The revised PTEs checklist is a valid and reliable screening tool that reflects NKDs’ unique trauma experiences across the pre-, peri-, and post-migration phases. Its combined use with the International Trauma Questionnaire is recommended for comprehensive trauma assessment and tailored intervention planning.
Objective To identify diagnosis-specific clinical and longitudinal predictors of suicide attempts in early-onset mood disorders, comparing major depressive disorder (MDD), bipolar I disorder (BD-I), and bipolar II disorder (BD-II) within a single cohort to inform targeted risk stratification.Methods We analyzed 430 patients aged under 35 years (a proxy for early-onset) with MDD, BD-I, or BD-II from a prospective South Korean cohort. Diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Mini International Neuropsychiatric Interview. Lifetime and follow-up suicide attempts and suicidal ideation (Beck Scale for Suicide Ideation, SSI-beck) were assessed using structured interviews and standardized scales. Logistic regression examined predictors of lifetime suicide attempts, and Cox proportional hazards models evaluated baseline predictors of time to first suicide attempt over approximately 60 weeks of follow-up.Results At baseline, 40.5% of patients reported a lifetime suicide attempt, and 62 patients attempted suicide during follow-up. In the total patients, earlier age at onset, longer untreated duration, alcohol use problems, psychiatric family history, and higher SSI-beck scores were associated with lifetime suicide attempts. Diagnosis-specific analyses showed distinct patterns. Prospectively, depressive severity and SSI-beck scores predicted first suicide attempts, with alcohol use and impulsivity additionally important in MDD.Conclusion Suicidal ideation and depressive severity are key transdiagnostic predictors of suicide attempts in early-onset mood disorders, while alcohol use, impulsivity, psychiatric family history, and illness burden mark diagnosis-specific risk profiles guiding tailored monitoring and interventions.
OBJECTIVE:To examine childhood and adult separation anxiety symptoms and their associations with attachment styles, personality traits, and sociodemographic factors among university students. METHODS:This cross-sectional study included 200 first-year university students. Attachment styles and personality traits were assessed using the Three-Dimensional Attachment Style Scale and the Five-Factor Personality Inventory, respectively. Based on validated cut-off scores from the Separation Anxiety Symptom Inventory and the Adult Separation Anxiety Questionnaire, participants were classified as screen-negative (n=48, 24%), childhood separation anxiety symptom-positive (CSAD) (n=30, 15%), adult separation anxiety symptom-positive (ASAD) (n=27, 13.5%), or childhood and adult separation anxiety symptom-positive (CSAD&ASAD) (n=95, 47.5%). Group differences were analyzed using non-parametric tests, and hierarchical regression examined factors associated with adult separation anxiety symptom scores. RESULTS:The CSAD&ASAD group showed significantly lower secure attachment and higher avoidant and anxious-ambivalent attachment scores compared with other groups. Emotional stability scores were significantly higher in the screen-negative group than in the ASAD and CSAD&ASAD groups. Parental separation/divorce and firstborn status were associated with higher symptom levels. In multivariable analyses, higher Beck Anxiety Inventory scores (β=0.275, p<0.001), lower emotional stability (β=-0.266, p<0.001), lower conscientiousness (β=-0.155, p=0.012), and firstborn status (β=-0.114, p=0.045) were independently associated with adult separation anxiety symptom scores, with the final model explaining 48.3% of the variance. CONCLUSION:Separation anxiety symptoms were common among university students. Findings highlight the role of internalizing symptom severity, personality traits, and selected sociodemographic factors in adult separation anxiety symptom scores. These findings should be interpreted at the symptom level and require confirmation through longitudinal and clinically structured studies.
OBJECTIVE:Distractor-embedded continuous performance test (CPT) paradigms have been developed to enhance the ecological validity and diagnostic precision of attention-deficit/hyperactivity disorder (ADHD) assessment. This study aimed to quantitatively synthesize the diagnostic performance of distractor-embedded CPT models and evaluate their incremental validity beyond traditional CPT paradigms. METHODS:A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. PubMed, Scopus, and Web of Science were searched through February 2026. Studies were included if they employed distractor-embedded CPT paradigms and reported sufficient data to compute standardized mean differences between ADHD and control groups. Hedges g was calculated for each study. Random-effects meta-analyses (DerSimonian-Laird method) were performed to estimate pooled effect sizes. RESULTS:Eight studies comprising 2,135 participants were included. The pooled standardized mean difference was 1.14 (95% confidence interval: 0.53-1.75), indicating substantial separation between ADHD and control groups. Subgroup analyses revealed comparable pooled effects for MOXO-based (|g|=1.26) and virtual reality (VR)-based paradigms (|g|=1.30), with lower heterogeneity observed in VR-based studies. Domain-specific analyses showed the largest effect for attention (g=1.35), followed by impulsivity (g=0.82) and hyperactivity (g=0.80). Incremental validity findings demonstrated improved diagnostic precision when eye-tracking augmentation and multivariate composite scoring methods were applied. Sensitivity analyses confirmed stability of the pooled estimates. CONCLUSION:Distractor-embedded and ecologically enriched CPT paradigms demonstrate robust diagnostic discrimination in ADHD assessment. Multimodal and integrated models may provide incremental advantages over conventional CPT approaches. These findings support the integration of ecologically valid and multimodal objective measures into ADHD diagnostic frameworks.
Objective This study examined whether duration of daily e-cigarette use was associated with anxiety symptoms among Korean adolescents, with comparisons across cigarette-only, e-cigarette-only, and dual-use groups. The study also evaluated whether negative health perception showed indirect effects in the association between duration of daily use and anxiety.Methods Data were drawn from the 2024 Korea Youth Risk Behavior Survey, a nationally representative sample of 54,653 middle and high school students. Primary analyses were restricted to 992 current users classified as cigarette-only, e-cigarette-only, or dual users. Anxiety symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7). Multiple linear regression models were used to examine associations between daily use duration and anxiety, and structural equation modeling (SEM) was conducted to estimate indirect effects involving negative health perception.Results Longer duration of daily e-cigarette use and dual use was significantly associated with higher GAD-7 anxiety scores, whereas duration of cigarette-only use was not. SEM findings showed statistically significant indirect effects involving negative health perception, with the smallest standardized indirect effect observed among e-cigarette-only users. Although statistically significant, the indirect effects were small in magnitude.Conclusion Among Korean adolescents, longer duration of daily e-cigarette use and dual use were associated with higher anxiety scores. Negative health perception also showed small but statistically significant indirect effects in these associations. These findings should be interpreted cautiously given the cross-sectional design and modest effect sizes, but they suggest that adolescent e-cigarette use may warrant attention in relation to anxiety symptoms and perceptions of health risk.
Objective To explore the current status and associated factors of stigma among postoperative thyroid cancer patients, and the association and potential pathways of post-traumatic growth (PTG) on stigma.Methods We adopted a mixed-methods design based on an explanatory sequential approach, encompassing both quantitative and qualitative methods. Quantitative analysis was performed utilizing the convenience sampling method, involving 184 post-operative patients with thyroid cancer from a tertiary hospital in Hunan Province for a cross-sectional survey. Data were collected via demographic questionnaires, the Social Impact Scale, and the Post-Traumatic Growth Inventory. Qualitative analysis was conducted through purposive sampling, and semi-structured in-depth interviews were conducted with 12 of the patients.Results The recruited patients had mean stigma and PTG scores of 61.62±13.33 and 60.54±14.78, respectively. We also found that PTG correlated significantly negatively with stigma (p<0.05). Hierarchical regression analysis further revealed that PTG accounted for 21.7% of the variance in stigma scores (p<0.05). Additionally, the qualitative analysis yielded three major themes and six subthemes: 1) reconstructing a positive mindset amid psychological struggles; 2) reconstructing illness cognition through social support; and 3) behavioral adaptation and self-identity reconstruction.Conclusion Thyroid cancer patients may experience some level of stigmatization post-surgery, which may be inversely correlated with their PTG levels. Therefore, researchers should develop clinical interventions to improve PTG via emotional regulation, cognitive restructuring, social support, and health behavior promotion.
Objective This study investigated physicians’ use of large language model (LLM)-generated assessments in psychiatric symptom evaluation and factors influencing their acceptance of artificial intelligence (AI) suggestions.Methods Twelve psychiatrists evaluated 50 anonymized psychiatric case vignettes, rating the presence and severity of 73 symptoms using a 4-point Likert scale. After initial assessment, they reviewed GPT-4o’s symptom ratings and could revise their evaluations. Accuracy was measured against a gold standard established by expert consensus. We computed initial (I), LLM (L), and revised (R) accuracy scores using percent agreement and weighted kappa. Performance improvement was measured by relative kappa increase. Regression analyses examined the influence of task difficulty and user competence on accuracy improvement.Results LLM assessments outperformed initial physician ratings in both agreement (90.4% vs. 82.9%, p<0.001) and kappa (0.713 vs. 0.559, p<0.001). After revision, physician performance improved (κ=0.651) but remained below LLM levels. The switch rate—cases where physicians revised in response to LLM disagreement—was modest (25.4%), indicating partial reliance on AI. Performance gains were positively associated with LLM accuracy and negatively associated with users’ own baseline competence, suggesting that less confident users rely more on LLM assistance.Conclusion Physicians demonstrated limited but strategic trust in LLM outputs, adjusting their judgments more when the LLM was accurate or when their own competence was lower. Miscalibrated trust—excessive skepticism or overreliance—led to missed gains. Effective human-AI collaboration in psychiatry requires tools and training for accurate self-assessment and AI trust calibration to avoid the pitfalls of algorithm aversion or overreliance.
Objective To evaluate the efficacy and safety of acupuncture in treating anxiety disorders in adults and provide evidence-based support for clinical practice.Methods Randomised controlled trials (RCTs) comparing experimental groups that received acupuncture for anxiety disorders with control groups that did not were retrieved from four databases (PubMed, Web of Science, the Cochrane Library, and Embase). The standardised mean difference (SMD) and relative risk (RR) of each, along with its 95% confidence interval (CI), were calculated.Results Twelve RCTs involving 1,240 patients were included in this meta-analysis. Meta-analysis results showed a significantly superior improvement in anxiety symptoms in the acupuncture group compared with the control group, based on both post-treatment scores (SMD=-0.80, 95% CI: -1.11 to -0.48, p<0.001) and change score values (SMD=-1.11, 95% CI: -1.56 to -0.65, p<0.001). Subgroup analyses demonstrated a consistent trend of efficacy across different assessment scales, and there was no significant difference in the incidence of adverse events between the acupuncture group and the control group (RR=1.97, 95% CI: 0.50 to 7.74). Sensitivity analysis did not reveal significant changes in the results, confirming the robustness of these findings.Conclusion Current evidence indicates that acupuncture is an effective and safe intervention for treating anxiety disorders in adults, significantly reducing anxiety symptoms with an incidence of adverse events comparable to that of a control group. It is recommended that acupuncture be considered an alternative option in the comprehensive management of anxiety disorders.
OBJECTIVE:This study aimed to evaluate the psychometric properties of the Chinese version of the Stress Sensitivity Inventory (SSI), a self-reported instrument that assesses trait stress sensitivity in adults, and to examine the relationship between the SSI and symptoms of internet gaming disorder (IGD). METHODS:The Chinese SSI was administered, along with the Internet Gaming Disorder Scale (IGDS) and scales assessing perceived stress, anxiety, depression, and neuroticism. Data from 1,085 valid respondents (with 347 respondents who retested 4 weeks later) were analyzed. A mixed graphical model was utilized to estimate the network structure properties of stress sensitivity and IGDS symptoms. RESULTS:Item #5 was removed due to low coherence with other items. The scale demonstrated a unidimensional structure with strong reliability (Cronbach's α=0.90, test-retest reliability=0.75) and validity. SSI scores were positively correlated with IGDS scores (r=0.42, p<0.001). In the SSI network, items with the highest expected influence were #8 (functional impairment), #6 (cognitive decline), and #3 (mental freeze). In the SSI-IGD network, items #8 (functional impairment) and #9 (substance use) showed the strongest bridge expected influence on the SSI side. CONCLUSION:The Chinese SSI demonstrates good reliability and validity, making it a suitable instrument for assessing stress sensitivity in both clinical and research settings. Network analysis revealed significant interconnections between stress sensitivity and IGD symptoms, with functional impairment (item #8) emerging as a particularly influential node both within the SSI cluster and in linking SSI to IGD.
Objective Studies have revealed the prognostic significance of intelligence in children with autism spectrum disorder (ASD), but the correlations of non-social cognitive functions and clinical characteristics of high-functioning children and adolescents with ASD remain unclear. To identify individual needs, this study aimed to investigate their correlations in high-functioning children and adolescents with ASD and conduct an exploratory comparison between subgroups.Methods We recruited children and adolescents who met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for ASD, excluding those with intellectual disability. The Wechsler Intelligence Scale for Children, Fourth Edition and Conners’ Continuous Performance Test, Second-Edition were administered to assess intelligence and attention. Their parents completed questionnaires, including the Child Behaviour Checklist, the Social Responsiveness Scale, and the Aberrant Behaviour Checklist, to report their clinical characteristics. Group differences were analyzed using t-tests and chi-square tests. Partial correlation was used to measure correlations between variables of cognitive tests and questionnaires, while adjusting for age, sex, and, where appropriate, the presence of attention-deficit/hyperactivity disorder.Results A total of 98 high-functioning participants with ASD were recruited (mean age, 11.44±3.13 years; 75.5% male). Significant correlations were found between their non-social cognitive functions and clinical characteristics. Specifically, Full Scale Intelligence Quotient (FSIQ), working memory, processing speed, attention, and impulse control were negatively associated with the severity of autistic, emotional, and behavioral symptoms. In addition, the Asperger’s disorder group demonstrated significantly better FSIQ, perceptual reasoning, working memory, processing speed, attention, and impulse control than the high-functioning autism group.Conclusion Significant correlations between non-social cognitive functions and autistic, emotional, and behavioral symptoms underscore the increased needs of high-functioning individuals with relatively poorer non-social cognitive abilities. Individualized support and management strategies can be developed and provided accordingly.
OBJECTIVE:Depression in children and adolescents is a global concern associated with adverse psychological and developmental outcomes. The Center for Epidemiologic Studies Depression Scale for Children (CES-DC) measures depressive symptoms in this population; however, evidence regarding its applicability in Korea remains limited. This study validated the Korean version of the CES-DC and examined its factor structure and associations with other psychological measures. METHODS:A total of 370 children and adolescents participated; 358 with complete CES-DC data were included, and 301 submitted the CES-DC retest after 2-4 weeks. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and Pearson correlations. Concurrent validity was assessed using parent-reported Child Behavior Checklist for ages 6-18 (CBCL 6-18) and self-reported Youth Self-Report (YSR) and the Revised Children's Manifest Anxiety Scale (RCMAS). Confirmatory factor analysis (CFA) evaluated model fit; exploratory factor analysis (EFA) explored variations in factor structure. RESULTS:The Korean CES-DC demonstrated high internal consistency (Cronbach's α=0.89) and good test-retest reliability (r=0.70), with subscale-level test-retest correlations (0.55-0.66). Significant correlations with the RCMAS and YSR, and weaker correlations with the CBCL, supported concurrent validity. CFA supported the fit of the original four-factor model. CONCLUSION:The Korean CES-DC is a reliable and valid measure for assessing depressive symptoms in children and adolescents. Further validation in broader age and clinical samples would strengthen generalizability.
OBJECTIVE:Evidence continues to accumulate indicating that grit could be a protective factor against suicidality. This study examined, over 6 months, whether each aspect of grit-consistency of interests and perseverance of effort-could be a protective predictor of suicidality in breast cancer patients and identified risk predictors for suicidality among them in a psycho-oncology clinic in a general hospital. METHODS:Three linear multivariable regression models of suicidality, evaluated at the baseline, at the 3-month, and 6-month time points each, as an outcome, were fitted with the potential predictor at baseline-grit aspects-and all other significant explanatory variables from each univariable model. Each multivariable model was adjusted for age and time passed since index cancer diagnosis. RESULTS:Of 154 patients with complete baseline data, 88 and 63 completed the 3-month and 6-month evaluations, respectively. Consistency of interests decreased suicidality at the 6-month time point. The degree of depressive symptoms and the intensity of present pain increased suicidality at the baseline and 6-month time point and at the baseline and 3-month time point, respectively. CONCLUSION:These results show that consistency of interests can be a novel protective predictor of suicidality. In addition, the intensity of current pain and the severity of depressive symptoms were associated with suicidality in the short and long term, respectively. Our findings show that suicidality among patients with breast cancer are influenced by predictors on multiple levels, which appear to change over time.
OBJECTIVE:This study examined whether depressive symptoms mediate the association between loneliness and subjective memory complaints (SMCs), and whether meaning in life (MIL) moderates this pathway, among middle-aged and older Korean adults. METHODS:A cross-sectional survey was conducted with 580 adults aged 41-71 years (mean age=58.80; 54.8% males). Participants completed measures of loneliness, depression, SMCs, and MIL. Mediation (PROCESS Model 4) and moderated mediation (Model 7) analyses were performed using 5,000 bootstrap resamples while adjusting for demographic covariates. Supplementary analyses examined MLQ subscales (Presence and Search for Meaning) and age-stratified models. RESULTS:Loneliness was significantly associated with depressive symptoms (β=0.523, p<0.001) and SMCs (β=0.131, p=0.008). Depression was also associated with SMCs (β=0.200, p<0.001) and partially mediated the loneliness-SMCs link (indirect effect=0.011; 95% confidence interval [CI] [0.006, 0.018]). The index of moderated mediation was significant (index=-0.0002, 95% CI [-0.0004, -0.0001]). MIL moderated the loneliness-depression association (interaction B=-0.005, p<0.001), with a stronger slope at low MIL (B=0.237) than at high MIL (B=0.148). Subscale analyses showed similar patterns for presence and search when tested separately, but neither showed a unique moderating effect when entered simultaneously. Age-stratified analyses showed depression mediated the loneliness-SMCs link only in older adults, whereas MIL attenuated the loneliness-depression association only in middle-aged adults. CONCLUSION:Loneliness was associated with SMCs partly through depressive symptoms, and MIL may buffer this pathway. These mechanisms differed by life stage, with stronger evidence for depression as a mediator in later life than in midlife, suggesting age-tailored approaches targeting emotional distress and life purpose.
OBJECTIVE:Accumulating evidence suggests that the latent structure of post-traumatic stress disorder (PTSD) symptoms may be more differentiated than the four-factor model proposed in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). While expanded factor models have been supported in trauma-exposed and community samples, their applicability in clinically diagnosed psychiatric outpatient populations remains unexplored. This study aimed to evaluate and compare competing DSM-5-based PTSD factor models in a general adult psychiatric outpatient sample using the Korean version of the PTSD Checklist for DSM-5 (K-PCL-5). METHODS:Psychological data were obtained from 229 adults who were first-visit psychiatric outpatients diagnosed with PTSD or probable PTSD at a university hospital in South Korea. PTSD symptoms were assessed using the K-PCL-5. Confirmatory factor analyses (CFA) were conducted to compare eight competing PTSD models, including one- and two-factor models, the DSM-5 four-factor model, and alternative multidimensional models (dysphoria, dysphoric arousal, externalizing behavior, anhedonia, and hybrid). Models were estimated using the weighted least squares mean- and variance-adjusted estimator for ordinal data. Model fit was evaluated using multiple fit indices. RESULTS:The DSM-5 four-factor model demonstrated a borderline fit. All alternative multidimensional models showed improved fit relative to the DSM-5 model. Among them, the seven-factor hybrid model provided the best overall fit, followed by the six-factor anhedonia and externalizing behavior models. One- and two-factor models demonstrated poor fit. CONCLUSION:PTSD symptoms in Korean adult psychiatric outpatients are better represented by expanded multidimensional factor models than by the DSM-5 four-factor model. These findings support the clinical applicability of post-DSM-5 expanded PTSD models and highlight the need for further validation across diverse clinical populations.
OBJECTIVE:To identify temperament-based subtypes and psychopathological profiles among court-referred juvenile offenders to inform individualized assessment and intervention strategies. METHODS:Seventy-two offenders were assessed using junior temperament and character inventory (JTCI) (novelty seeking, harm avoidance, and reward dependence). Subtypes were identified via two-step cluster analysis and compared using Minnesota Multiphasic Personality Inventory-Adolescent-Restructured Form (MMPI-A-RF) scores. RESULTS:Three stable subgroups emerged: relationship-dependent conformist (Cluster 1; 25.0%), isolated internalizing risk (Cluster 2; 38.9%), and impulsive externalizing risk (Cluster 3; 36.1%). Cluster 1 showed minimal psychopathology. Clusters 2 and 3 both exhibited elevated psychopathology relative to Cluster 1, including comparable elevations in thought dysfunction and ideas of persecution. However, the two high-risk clusters differed in their relative profiles: Cluster 2 showed higher social withdrawal (elevated introversion/low positive emotionality), whereas Cluster 3 demonstrated relatively greater behavioral disinhibition, reflected in elevated behavioral/externalizing dysfunction, antisocial behavior, and disconstraint. CONCLUSION:Temperament-based subtyping reveals clinically meaningful heterogeneity even among offenders with similar levels of distress. Integrating JTCI and MMPI-A-RF enhances assessment precision and supports tailored forensic interventions.
OBJECTIVE:Caregiver burden shows substantial variability across caregiving contexts. This study examined whether caregiver personality traits, particularly neuroticism, moderate the associations between care-recipient factors such as cognitive impairment severity and neuropsychiatric symptoms, and caregiving-related outcomes including overall burden and symptom-related distress. METHODS:Cross-sectional data from 214 care-recipient and caregiver dyads attending a geriatric psychiatry clinic were analyzed. Cognitive impairment severity was assessed using the Clinical Dementia Rating (CDR), and neuropsychiatric symptoms were measured with the Neuropsychiatric Inventory (NPI). Caregiving-related outcomes were evaluated using the Zarit Burden Interview (ZBI) and the NPI distress (NPI-D). Caregiver personality traits were assessed with the Big Five Inventory-Korean version. Linear regression models tested associations between care-recipient factors and caregiving-related outcomes, and multiple linear regression models examined moderation by caregiver personality using interaction terms, adjusting for caregiver age, sex, and cohabitation status. RESULTS:Caregiver neuroticism significantly moderated the associations between cognitive impairment severity and both overall caregiving burden and symptom-related distress by amplifying these associations (CDR×neuroticism interactions: ZBI, B [standard error, SE]=7.948 [3.387], p=0.020; NPI-D, B [SE]=4.498 [1.383], p=0.001). CONCLUSION:Caregiver neuroticism appears to be a key modifier of how cognitive impairment severity translates into overall caregiving burden and symptom-related distress. Incorporating caregiver personality assessment may improve risk stratification and inform more personalized support approaches for caregivers of individuals with cognitive impairment.
Objective Quality sexual relationships predict higher marital satisfaction and lower emotional distress in cancer patients. However, no studies have investigated the sexual satisfaction of patients visiting a psycho-oncology clinic. In this study, I examined characteristics of non-respondents to a sex-related question and identified characteristics and correlates of sexual satisfaction in patients visiting a psychooncology outpatient clinic in a tertiary hospital in a sex-stratified format.Methods For 417 female and 169 male, those who answered the single sexual satisfaction item of the Functional Assessment of the Cancer Therapy-General (FACT-G) were categorized as “respondents,” and others as “non-respondents” by sex. After adjusting for age, cancer diagnosis, and time after diagnosis, sex-stratified linear regression models were established using the FACT-G except the sexual item and the Hospital Anxiety and Depression Scale.Results Female were 1.466 times more likely to decline to answer about sexual satisfaction. Older patients, and female with active diseases or recent chemotherapy, also tended to avoid answering. Among female and male, 24.5% and 26.0%, respectively, reported no sexual satisfaction, with no between-sex difference. Lower age, a longer time since diagnosis, greater social/family well-being, and lower depressive symptoms for female and greater physical well-being for male contributed to sexual satisfaction.Conclusion Psycho-oncologists should sensitively address sexual issues among older female in poor health. Paying equal attention to sexual issues for both sexes is necessary. For recently diagnosed older female with lower social/family well-being and higher depressive symptoms and male experiencing lower physical well-being, sexual issues should be thoroughly assessed.
OBJECTIVE:This study aimed to investigate the association between the timing of mental disorder diagnosis and all-cause mortality among patients with coronavirus disease 2019 (COVID-19) during the initial period of the pandemic. METHODS:This retrospective study used the K-COV-N cohort (Korea Disease Control and Prevention Agency-COVID-19-National Health Insurance Service cohort). Patients with confirmed COVID-19 between October 2020 and December 2021 were classified into three groups: those without mental disorders, those with pre-existing mental disorders, and those with newly diagnosed mental disorders during the COVID-19 pandemic. Logistic regression analysis was performed to estimate the association between mental disorder group and all-cause mortality. RESULTS:A total of 432,852 patients with COVID-19 were included in the analysis. Of these, 351,519 (81.21%) had no mental disorders, 54,846 (12.67%) had pre-existing mental disorders, and 26,487 (6.12%) had newly diagnosed mental disorders during the pandemic. The overall all-cause mortality rate was 0.72% (n=3,099). Compared with patients without mental disorders, those with pre-existing mental disorders (adjusted odds ratio [aOR], 1.33; 95% confidence interval [CI], 1.21-1.47) and those with newly diagnosed mental disorders (aOR, 1.63; 95% CI, 1.44-1.84) had higher odds of all-cause mortality. CONCLUSION:Among patients with COVID-19, both pre-existing and newly diagnosed mental disorders were associated with increased all-cause mortality, with a stronger association observed for newly diagnosed mental disorders.
