Hospital-Based Case Management for Suicide High-Risk Group Using Delphi Survey

Hwan Lee,Jeungsuk Lim,Sang Min Lee,Soung Nam Kim,Haewoo Lee,Kyoung-Uk Lee,Boung Chul Lee,Hwa-Young Lee,Jong-Woo Paik 대한신경정신의학회 2021 PSYCHIATRY INVESTIGATION Vol.18 No.10

Objective As of 2019, suicide is serious problem in Korea, with the highest suicide rate among OECD countries. To reduce suicide rates Emergency Department Based Post-Suicide Attempt Case Management carried out with government funding in South Korea, but it is insufficient to address the issue. Aim of this study is to prevent suicide attempts through continuous provision of mental health services even after discharge from acute care. Methods We selected 15 mental health specialists who are multidisciplinary experts in Suicide Prevention. Two-round Delphi survey was conducted on them to reach an agreement for hospital-based case management. Results The first Delphi survey consisted of 8 areas and 39 questions. Among them, 30 questions draw agreement above the reference value. The second Delphi survey, consisted of 37 questions, resulted in 32 above-standard questions. Conclusion Consensus was reached in most category of the Hospital Based Case Management for Suicide High-Risk Group. Core of the developed plan was to provide services to patients who visited the hospital, pursue the stability and universalization of services through a medical insurance fee system. In the future, hospital-based case management service will be implemented as a new model contributing to the reduction of suicide rates in Korea.

Risk of Breast Cancer in Association with the Use of Second-generation Antipsychotics

Sung Woo Joo(Sung Woo Joo),Boung Chul Lee(Boung Chul Lee),Jungsun Lee(Jungsun Lee),Gi Hyeon Seo(Gi Hyeon Seo) 대한정신약물학회 2022 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.20 No.4

Objective: Previous studies regarding the relationship between the risk of breast cancer (BC) and antipsychotics use have reported inconsistent findings. Insufficient sample size and/or observation period may have hindered revealing the risk of BC associated with antipsychotics use. We aimed to investigate whether the use of second-generation antipsychotics (SGA) is associated with increased risk of BC. Methods: We used the Health Insurance Review Agency database in South Korea between 2008 and 2018. The index date was determined as the date of the first antipsychotic prescription. We selected women prescribed SGAs for more than 30 days within a year from the index date and age-matched controls, yielding 498,970 cases and 997,940 controls. The Cox proportional hazards regression model was used for estimating the risk. Results: The incidence rates of BC were 109.74 and 101.51 per 100,000 person-years in the case and control groups, respectively. There was an increased risk of BC in the case group (hazard ratio [HR] = 1.08, 95% confidence interval [CI] 1.04−1.13). There was a higher risk of BC in subjects prescribed with ≥ 10,000 mg of olanzapine equivalent dose (HR = 1.29, 95% CI 1.14−1.46) than those with < 10,000 mg (HR = 1.05, 95% CI 1.00−1.11). The increased risk of BC in the case group became significant after six years of the observation period (≥ 6 years: HR = 1.24, 95% CI 1.14−1.35, 3 to < 6 years: HR = 1.06, 95% CI 0.97−1.15, < 3 years: HR = 1.02, 95% CI 0.95−1.09). Conclusion: This study indicated that the use of SGAs is associated with increased risk of BC in a long-term relationship with a dose-response pattern.

The Impact of Emotional Exhaustion on Psychological Factors in Workers with Secondary Traumatic Experiences: A Multi-Group Path Analysis

Min Jin Jin,Ji Sun Kim,Ho-Sung Lee,Young Joon Kwon,Se Hoon Shim,Bum-Sung Choi,Dong-Woo Lee,Jong-Woo Paik,Boung Chul Lee,Sung-Won Jung,Hwa-Young Lee 대한신경정신의학회 2020 PSYCHIATRY INVESTIGATION Vol.17 No.11

Objective The objective of the present study was to explore causal pathways to understand how second traumatic experiences could affect the development of emotional exhaustion and psychiatric problems. Methods A total of 582 workers who had jobs vulnerable to secondary traumatic experiences were enrolled for this study. Emotional exhaustion, secondary trauma, resilience, perceived stress, depression, anxiety, and sleep problems were evaluated. A model with pathways from secondary traumatic experience score to depression and anxiety was proposed. The participants were divided into three groups according to the resilience: the low, middle and high resilience group. Results Resilience was a meaningful moderator between secondary traumatic experiences and psychiatric problems. In the path model, the secondary trauma and perceived stress directly and indirectly predicted perceived stress, emotional exhaustion, depression, anxiety, and sleep problems in all three groups. Direct effects of perceived stress on depression and anxiety were the largest in the low resilience group. However, direct effects of secondary trauma on perceived stress and emotional exhaustion were the largest in the high resilience group. Conclusion Understanding the needs of focusing for distinct psychological factors offers a valuable direction for the development of intervention programs to prevent emotional exhaustion among workers with secondary traumatic experiences.

Factors Associated with Emotional Exhaustion in South Korean Nurses : A Cross-Sectional Study

Bum-Sung Choi,Ji Sun Kim,Dong-Woo Lee,Jong-Woo Paik,Boung Chul Lee,Jung Won Lee,Ho-Sung Lee,Hwa-Young Lee 대한신경정신의학회 2018 PSYCHIATRY INVESTIGATION Vol.15 No.7

Objective We examined associations between emotional exhaustion and selected sociodemographic and psychological factors among nurses in inpatient and outpatient nursing units at a university hospital in South Korea. Methods The participants were 386 nurses who completed the Maslach Burnout Inventory, a measure of emotional exhaustion. Psychological characteristics were evaluated, including hardiness, self-esteem, experience of trauma, resilience, perceived stress, and social support. Correlation analyses examined the relationships between emotional exhaustion with sociodemographic, occupational, and psychological characteristics. Linear regression was used to evaluate the associations between emotional exhaustion and the assessed characteristics. Results Higher emotional exhaustion scores were associated with greater depression, anxiety, traumatic experience, and perceived stress. Exhaustion was inversely associated with hardiness, self-esteem, resilience, and quality of life. The regression analysis indicated that gender, marriage, resilience, depression, perceived stress, and secondary traumatic stress were significantly associated with emotional exhaustion. Conclusion This study showed that psychological characteristics, such as resilience, depression, and secondary traumatic experiences, may cause emotional exhaustion. Understanding the needs of people with distinct demographic and psychological characteristics offers valuable direction for the development of intervention programs to prevent burnout among nurses.

The Sewol Ferry Accident and Early Mental Health Care Response by Volunteer Activities of Korean Disaster Mental Health Committee and Members of Korean Neuropsychiatric Association

Jong- Woo Paik,Hyun- Soo Kim,Minyoung Sim,Hae- Kook Lee,Young Sup Woo,Chanseung Chung,Sang- Hyuk Lee Jeong- Ho Seok,Hong Jin Jeon,Sang- Min Lee,Soo- Young Bang,Kyoung- Sae Na,Boung Chul Lee,Myung- Soo 대한신경정신의학회 2015 신경정신의학 Vol.54 No.1

On 16 April 2014, the Sewol ferry, carrying 476 people, sank in the ocean off the south coast of South Korea. Two hundred and ninety five are confirmed dead and 9 remain missing. The Korean Neuropsychiatric Association (KNPA) set up a Disaster Mental Health Committee (KDMHC) for out- reach services and to provide general strategies for promoting mental health and resilience. Mem bers of KDMHC and Volunteering Psychiatrists of the KNPA had participated in disaster mental health services organized by Gyeonggi- Ansan disaster mental health support team. Their activities were composed of psychoeducation, supportive individual and familial counseling and referring service to professional institutes. This report has described the outline of the initial and acute mental health care responses by KDMHC and volunteers among KNPA members.

Effects of Paliperidone Palmitate on Healthcare Utilization and Costs for Patients with Schizophrenia: A Claim-based Mirror-image Study in South Korea

Dasom Lee,Boung-Chul Lee,최수희,Do-Hyung Kang,전덕인,Myung Hun Jung 대한정신약물학회 2020 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.18 No.2

Objective: Long-acting injectable (LAI) antipsychotics, such as paliperidone palmitate (PP), are known to improve treatment adherence in patients with schizophrenia, which can lead to reductions in relapse and hospitalization rates. However, relatively few studies have demonstrated the economic impact of LAIs, especially in Asian populations. Methods: We conducted a claim-based mirror-image study to explore changes in healthcare utilization and associated costs, among 1,272 South Korean patients with schizophrenia (ICD-10-CM code F20), between the 1-year periods before and after the initiation of PP treatment. Results: Patients accessed outpatient services more frequently after versus before starting PP treatment, with the number of prescription days increasing by 133.45 (p < 0.0001) and the associated costs increasing by USD 1,497.15 (p < 0.0001). The number of admission days was reduced by 11.33 after starting PP treatment (p < 0.0001) and the associated costs were reduced by USD 1,220.75 (p < 0.0001). However, admission cost savings were different according to patients’ oral drug compliance. The daily dosages for benztropine, procyclidine, and propranolol decreased, showing that there were fewer side-effects after PP-treatment (p < 0.0001). Conclusion: Although the high acquisition cost of PP has been regarded as an obstacle to its clinical use, our results imply that the high prescription costs for PP may be counterbalanced by the reduced admission costs associated with its use. Economic outcomes for patients treated with LAIs should be investigated further to help healthcare decision-makers and providers to determine the value of LAIs relative to other treatment medications.

국가 심층 웹기록물 보존 포맷과 OAIS 참조모델 간의 데이터 맵핑

박병주(Boung-Joo Park),차승준(Seung-Jun Cha),이규철(Kyu-Chul Lee) 한국정보과학회 2010 한국정보과학회 학술발표논문집 Vol.37 No.1C

웹 기술이 발달함에 따라 공공기관 웹사이트는 단순한 행정기관의 홍보에서 벗어나 국민과 정부 간의 의사소통의 증거인 동시에 업무의 기록으로서 역할을 담당하고 있다. 따라서 공공기관의 웹사이트들은 공공기록물로 인식하고 보호해야 한다. 하지만 공공기관의 웹기록물 중 하나인 심층 웹기록물은 실시간으로 상이한 페이지를 동적으로 구성하기 때문에 기존의 보존방법과는 다른 수집?보존?활용 기술이 요구된다. 국가기록원은 이러한 특징을 가지고 있는 심층 웹기록물을 장기보존하기 위해서 심층 웹기록물 장기보존 포맷인 KoDeWeb을 연구하고 개발하였다. KoDeWeb은 전자기록물이기 때문에 전자기록물로서 진본성 및 무결성을 보장해야 한다. 본 연구에서는 KoDeWeb의 전자기록물로서의 진본성 및 무결성을 증명하기 위해 국제 전자기록물 표준인 OAIS 참조모델에 KoDeWeb을 맵핑시켰다. 나아가 OAIS표준을 따르고 있는 전자기록물 장기보존 시스템에 KoDeWeb을 사용함으로써, 정부 및 공공기관의 심층 웹기록물 생성 및 수집을 체계화하고, 또한 민간이 운영하는 웹의 심층 웹기록물 장기보존에 활용할 수 있다.

웹기록물 보존을 위한 전자기록물 장기보존포맷 확장 설계

박병주(Boung-Joo Park),차승준(Seung-Jun Cha),이규철(Kyu-Chul Lee) 한국전자거래학회 2010 한국전자거래학회지 Vol.15 No.4

웹기록물은 공공기관의 업무활동이나 전자상거래에 대한 법적증거로 활용될 수 있기 때문에 보존할 가치가 있는 정보이지만 웹기록물의 특징 중 하나인 ‘휘발성’으로 인해 소실되고 있다. 따라서 이렇게 사라지는 웹기록물을 장기보존하기 위한 장기보존포맷이 정의되어야 한다. 웹기록물은 전자기록물의 일종이기 때문에 전자기록물 장기보존포맷에 보존할 수 있어야 한다. 하지만 현재 표준으로 제시된 포맷은 웹기록물의 특성을 고려하지 않고 정의되었기 때문에 웹기록물을 보존할 수 없다. 본 논문에서는 표면/심층 웹기록물 문서보존포맷으로 연구된 KoDeWeb/KoSurWeb과 전자기록물 장기보존포맷을 분석하고, 이를 바탕으로 웹기록물을 보존할 수 있는 확장된 전자기록물 장기보존포맷을 정의하였다. 정의된 포맷을 활용하면 웹기록물도 전자기록물들과 같이 보존되어 활용될 수 있고, 전자 상거래에 관련된 공공기관의 웹기록물을 보존함으로써 전자 상거래에 대한 법적 증거로서 활용될 수 있다. Web records is valuable information to preserve, because it can be used as a legal evidence about business or e-commerce of a public institution, but it is easily disappeared because of its volatile characteristic. Therefore, archival information package should be defined for long-term preservation. Web records can be stored in the archival information package for electronic records, because web records is a kind of electronic records. However, the NEO(NARS Encapsulation Object), the archival information package for electronic records in Korea, can’t able to store web records, because it was developed without consideration of the characteristic of web records. In this paper, we define extended NEO based on the analysis of KoSurWeb and KoDeWeb, that archival information package for document of surface and deep web as well as the NEO. Web records can be preserved and utilized along with electronic records by using the extended NEO. Also it can be used for record and legal evudence by archiving web records of public institution about e-commerce.

치매환자를 위한 어플리케이션에 대한 연구

이철민(Lee Chul?min),임병규(Lim Boung-gyu),송은지(Song Eun-jee) 한국정보기술학회 2018 Proceedings of KIIT Conference Vol.2018 No.11

항우울제와 자살

이병철,함병주,Lee, Boung-Chul,Ham, Byung-Joo 대한생물정신의학회 2006 생물정신의학 Vol.13 No.4

Depression is a frequent cause of suicide. Although there have been reports that SSRIs might increase suicidal ideations and behaviors, most studies found antidepressants are effective treatments of suicidal ideations and behaviors. Antidepressants have also been shown to have prophylactic effects in preventing suicidal behaviors. Most double-blind studies do not suggest a causal relationship between antidepressant and the increased suicidality. Our review results suggest that the undertreatments of depression are more significant problems with the use of antidepressants in suicidal patients.