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Considering the high prevalence of depression and anxiety among thalassemia patients and the role of social support in preventing mental disorders, this study aimed to determine prevalence of depression, anxiety, and perceived social support (PSS) among adults with beta-thalassemia major.
This cross-sectional study was performed with 389 adults with beta-thalassemia major. Data were collected via a questionnaire consisting of three parts: demographic and medical information, the Persian version of the hospital anxiety and depression scale, and the Persian version of the Multidimensional Scale of Perceived Social Support. Data were analyzed using IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA) through analytical statistics (independent-samples t-test, one-way analysis of variance, Pearson correlation coefficient, and multilevel linear regression), and the results less than 0.05 were considered to be significant.
The mean scores of depression, anxiety, and PSS of patients were 7.42±3.17, 7.47±4.35, and 41.8±8.64, respectively. Of 389 patients, 19.8% had depression and 23.7% had an anxiety disorder. Relationships of depression and anxiety with age, the level of education, job, and family income were statistically significant, as were those of PSS with age, thalassemia center, family income, job, and the level of education. PSS from family, friends, and significant others were the significant predictive factors of depression and anxiety among adult patients with beta-thalassemia major.
Considering the PSS as a factor influencing the reduction in depression and anxiety in thalassemia patients, social support from the social networks (spouse, family members, friends, and healthcare workers) should be integrated with interventions that are designed to improve the mental and physical health of thalassemia patients.
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Recently, several institutions, including the American Academy of Sleep Medicine, the Sleep Research Society, and the National Sleep Foundation, have made consensus recommendations concerning appropriate sleep duration for adults. Although numerous studies conducted in Western populations have provided evidence of the harmful effects of short or long sleep duration on mental health, it is still unclear whether these consensus recommendations are appropriate in Korean culture.
Data from 1,892 subjects with no history of medical or psychiatric diagnoses were selected from the Korea National Health and Nutrition Examination Survey of 2014. Subjects were divided into seven groups based on their sleep duration (≤4, 5, 6, 7, 8, 9, and ≥10 hours). Depressive symptoms were measured using the Patient Health Questionnaire-9 and perceived stress severity was evaluated using a Likert-type scale. Group differences in depressive symptoms and severity of stress were analyzed using an analysis of covariance.
Depressive symptoms in subjects with sleep duration of ≤4 hours (5.7±5.9) or 5 hours (3.4±3.9) were higher than in subjects with a sleep duration of 7 (2.2±2.9) or 8 hours (2.2±2.9) (corrected P<0.05). Furthermore, subjects with a short sleep duration (5 hours or below) had greater perceived stress severity than subjects with a sleep duration of 7 or 8 hours (corrected P<0.05).
Our results suggest that maintaining an appropriate sleep duration as found in the recent consensus recommendation is important for mental health, even in healthy subjects without any medical or psychiatric illnesses, in Korea.
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Psychiatric symptoms may be related to a silent cerebral infarct, a phenomenon that has been described previously in literature. Acute psychosis or other neuropsychiatric symptoms including depression may present in stroke patients and patients with lesions either within the prefrontal or occipital cortices, or in subcortical areas such as the basal ganglia, thalamus, mid-brain, and brainstem. Psychosis in clinical stroke or in silent cerebral infarction is uncommon and not well documented in the literature. Neurological deficits are the most common presentation in stroke, and nearly a third of patients that suffer a stroke may experience psychological disorders such as depression and anxiety, related to physical disability. The present case report describes an elderly female patient who presented with hallucinations and depressive symptoms, and was discovered to have a recent right frontal brain infarction, without other significant neurological deficits.
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The number of North Korean adolescent defectors entering South Korea has been increasing. The health behavior, including mental health-related behavior, and factors associated with depression in North Korean adolescent defectors residing in South Korea were investigated.
Data obtained from the Korea Youth Risk Behavior Web-Based Survey (2011–2014) dataset were utilized. In total, 206 North Korean adolescent defectors were selected, and for the control group, 618 matched South Korean adolescents were selected. Frequency analysis was used to determine the place of birth and nationality of the parents, chi-square tests were used to compare the general characteristics of the North and South Korean subjects, and multivariate logistic regressions were conducted to compare the health behavior of the two sets of subjects. To determine the factors associated with depression in the North Korean subjects, a logistic regression was performed.
The North Korean adolescents reported higher current smoking (adjusted odds ratio [aOR], 2.54; 95% confidence interval [CI], 1.48 to 4.35), current drinking (aOR, 1.85; 95% CI, 1.15 to 2.99), and drug use rates (aOR, 10.99; 95% CI, 4.04 to 29.88) than did the South Korean adolescents. The factors associated with depression in the North Korean adolescents were current smoking (aOR, 6.99; 95% CI, 1.62 to 30.06), lifetime drinking experience (aOR, 5.32; 95% CI, 1.51 to 18.75), and perceived stress (aOR, 4.74; 95% CI, 1.74 to 12.90).
There were differences in health behavior between the North and South Korean adolescents. A specialized approach for North Korean adolescent defectors is required to promote proper health behavior and adaptation to South Korean society.
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Depression is prevalent in patients with chronic kidney disease (CKD) and continues to increase in elderly adults. Therefore, the aim of our study was to examine the relationship between CKD and depression in older patients.
We conducted a cross-sectional study based on 2013 Korea National Health and Nutrition Examination Survey data. In total, data of 973 subjects aged ≥65 years were analyzed, and the estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation.
The prevalence of depression in older adults was 4.1% in men and 8.8% in women (P=0.004). The prevalence of depression did not differ according to CKD stage in women (normal eGFR and CKD stages 1 and 2 women, 41/474 [8.6%]) vs. CKD stages 3–5 women, 6/63 [9.5%]); however, the prevalence of depression in men with CKD stages 3–5 (8/83 [9.6%]) was significantly higher than in men with normal eGFR and CKD stage 1 and 2 (10/353 [2.8%], P=0.010). Multivariate logistic regression analysis showed that the odds ratio for depression in men with CKD stages 3–5 was 3.822 (95% confidence interval, 1.229 to 11.879) after adjusting for social status and chronic diseases (P=0.021).
The prevalence of depression was higher in elderly women than in men, while the prevalence of depression increased in elderly men with CKD stages 3–5 and was almost equal to that of women. Therefore, elderly men with progressive renal function impairment should be counseled and monitored for psychological problems.
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The prevalence of hearing impairment is increasing and an association between hearing impairment and mental health has been reported. Our study aimed to determine the association between hearing impairment and mental health in Korea.
This was a cross-sectional study of data from the Korean National Health and Nutrition Examination Survey 2010–2013, with a sample size of 18,563 individuals (6,395 with hearing impairment and 12,168 without hearing impairment), aged ≥20 years.
The female group with hearing impairment tended to have a higher rate of stress (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.11 to 1.56). The association between hearing impairment and depressive symptoms was higher in elderly males (OR, 1.60; 95% CI, 1.10 to 2.32), while the association of hearing impairment with suicide ideation was higher in elderly females (OR, 1.32; 95% CI, 1.00 to 1.75).
Elderly individuals with hearing impairment are easily susceptible to poor mental health status. Early targeted intervention to address mental health problems is recommended for people with hearing impairment.
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This cross-sectional study aimed to evaluate the prevalence of depressive disorders and factors associated in long-term cancer survivors.
A total of 702 long-term cancer survivors over 5-years in remission were recruited in a university-affiliated tertiary hospital in Korea. Self-report using the Patient Health Questionnaire-2 and the Fatigue Severity Scale assessed depression and fatigue, respectively. Demographic characteristics, cancer-related clinical characteristics, comorbidity, health behaviors, and physical symptoms were assessed through the review of medical records or a structured self-administered questionnaire.
We identified 26.1% of patients who had a depressed mood or displayed a loss of interest. The most prevalent primary site of cancer was the stomach (65.2%), followed by lung, breast, colorectal, and thyroid cancer. We also found that 5.7% of subjects experienced double or triple primary cancers. Larger proportion among depressive group (89.1%) complained at least one physical problem than among non-depressive group (53.2%). Physical symptoms including sleep problems, dry mouth, indigestion, pain, decreased appetite, and febrile sense were more frequent in the depressive group than in the non-depressive group. The Fatigue Severity Scale scores were higher in the depressive group than in the non-depressive group (P<0.001). Multiple logistic regression analysis showed that the highest tertile level of fatigue (odds ratio, 7.31; 95% confidence interval, 3.81–14.02) was associated with the increased risk of depression.
These findings suggest that careful concern about depression is necessary in long-term cancer survivors. Fatigue may be a surrogate sign for depression, and warrants further evaluation.
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We examined the relationship between vitamin D status and health-related quality of life, and explored other related factors in the general Korean population.
We used data from the 2007–2012 Korea National Health and Nutrition Examination Survey on 14,104 adults, aged 20–49 years, who had consented to serum vitamin D measurement and answered health-related quality of life questions. EuroQol-5 was used for measurement. Serum vitamin D levels were measured at intervals of 0–9.99, 10–19.99, 20–29.99, and ≥30 ng/mL.
Participants with higher serum vitamin D (serum 25-hydroxyvitamin D) levels were significantly less likely to report problems with depression and anxiety. After adjustment for age, gender, income level, education level, marital status, alcohol consumption, smoking status, and the existence of depressive disorders, the odds ratio for reporting a problem with depression and anxiety was 0.60 (95% confidence interval [CI], 0.39–0.91). The odds ratio for the prevalence of any problem was 0.69 (95% CI, 0.53–0.89) before adjustment, but was not statistically significant after adjustment. No significant associations were observed for problems with mobility, self-care, usual activity, or pain and discomfort.
This is the first study to examine the associations between vitamin D and health-related quality of life for the general Korean population. Vitamin D status was not significantly associated with the dimensions of EuroQol-5 except for depression and anxiety problems.
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Frailty refers to the loss of physiologic complexity and the associated decline in ability to withstand stressors as one gets older. It is defined as unintentional weight loss, exhaustion, weakness, slow walking speed, and low physical activity. According to several western studies, frailty is associated with cognitive impairment, but there have been few studies about the relationship between frailty and cognitive impairment in Korea. Thus, the purpose of this study is to analyze the relationship between cognition and factors related to frailty such as grip strength, walking speed, physical activity, and depression, among female patients older than 65 in Korea.
A total of 121 subjects among the outpatients of the department of family medicine at Kangbuk Samsung Hospital who did not meet the exclusion criteria were included in this study. We divided the participants into 2 groups, according to the Korean version of the Montreal Cognitive Assessment (MoCA) score: 1 group with subjects that had normal cognition and the other group with patients that had impaired cognition. A comparison was made between the 2 groups in regards to the factors related to frailty, and we completed equation that predicting cognition from the frailty related factors.
Compared with the impaired cognition group, the subjects in the normal cognition group had higher hand strength, and walked faster (P<0.001). There was no statistically significant difference in physical activity between the 2 groups (P=0.19). When multiple linear regression analysis was performed using age, grip strength, and walking speed as the predictor variables and MoCA score as the dependent variable, the regression coefficients were calculated to be: -0.2015, 0.2294, 1.2372, and -0.1436, respectively (P<0.05).
In Korean female patients who are older than 65 years of age, cognition tends to decline as grip strength decreases, walking speed gets slower, depression becomes more severe, and as age increases.
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In the majority of cases of bipolar disorder, manic episodes are usually brief and typically responsive to currently available psychopharmacological agents. In contrast, depressive manifestations are more prevalent and persistent, and can present as major depressive/mixed episodes or residual interepisode symptoms. The depressive phase is often associated with other neuropsychiatric conditions, such as anxiety spectrum disorders, substance use disorders, stressor-related disorders, and eating disorders. It is viewed as a systemic disease with associated ailments such as metabolic syndrome, diabetes mellitus, and cardiovascular disease. There is an increased rate of mortality not only from suicide, but also from concomitant physical illness. This scenario is made worse by the fact that depressive symptoms, which represent the main disease burden, are often refractory to existing psychotropic drugs. As such, there is a pressing need for novel agents that are efficacious in acute depressive exacerbations, and also have applicable value in preventing recurrent episodes. The rationale of the present review is to delineate the pharmacotherapy of the depressive phase of bipolar disorder with medications for which there is evidence in the form of observational, open-label, or double-blind randomized controlled studies. In the treatment of acute bipolar depression in adults, a comprehensive appraisal of the extant literature reveals that among mood stabilizers, the most robust proof of efficacy exists for divalproex sodium; while atypical antipsychotics, which include olanzapine, quetiapine, lurasidone, and cariprazine, are also effective, as demonstrated in controlled trials.
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In various studies in adults, caffeine may increase wakefulness and relieve pain, but caffeine overdose can cause many adverse serious effects on health. Caffeine intake has recently been increasing in adolescents. In spite of importance of caffeine effects on Korean adolescents, there are lack of scientific and systematic studies. The purpose of our study was to identify the relationship between caffeine consumption and effects on adolescents.
We performed study on 234 middle school students at one middle school in Daegu using a self-report questionnaire. We divided students to quartiles according to amount of caffeine intake. We used Beck Depression Inventory (BDI) to evaluate the degree of depression and Beck Anxiety Inventory (BAI) to evaluate the degree of anxiety. We also used Insomnia Severity Scale (ISI) to evaluate the degree of insomnia and Global Assessment of Recent Stress (GARS) to evaluate the stress in students. We used logistic regression analysis to identify the relationship between caffeine consumption and effects.
Higher caffeine intake was associated with higher weight, height, lower academic achievement, and higher score in BDI, BAI, ISI, and GARS (P for trend <0.005). Higher caffeine intake quartile was associated with greater odds of having significant depression (BDI ≥10, P for trend=0.011), and insomnia (ISI ≥8, P for trend=0.015) after adjustment for factors that can affect the psychological status.
We found that caffeine intake is associated weight, height, academic achievement, and higher score in BDI, BAI, ISI, and GARS. Caffeine intake was positively associated with the severity of depression and the severity of insomnia among adolescents in Korean.
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