Examining the Psychometric Properties and Clinical Correlates of the Korean Version of the Family Accommodation Scale-Self-Rated Version for Obsessive-Compulsive Disorder

Chang Jhin Goo,Lee Hye Min,Kim Se Joo,Kim Chan-Hyung 대한신경정신의학회 2022 PSYCHIATRY INVESTIGATION Vol.19 No.3

Objective We aimed to develop a Korean version of the Family Accommodation Scale-Self-Rated (FAS-SR), to investigate its reliability and validity and to study the clinical correlates of family accommodation in families with obsessive compulsive disorder (OCD) patient.Methods The FAS-SR was translated into Korean under the original author’s supervision. Forty-two patients with OCD and their closest relatives participated. The internal consistency was estimated using Cronbach’s alpha and the split half method. Convergent and divergent validity were identified by measuring with other clinical variables. Test-retest reliability was also calculated.Results The reliability analyses showed that Korean version of the FAS-SR demonstrated excellent internal consistency (Cronbach’s alpha=0.91) and test-retest reliability (Intraclass correlation coefficient=0.93). It showed good convergent validity when simultaneously assessed OCD symptom severity, global functioning and relative’s psychological distress.Conclusion The findings suggest that Korean version of the FAS-SR is a reliable and valid tool for assessing family accommodation in Korean patients with OCD in both research and clinical settings.

Association between Therapeutic Alliance and Adherence in Outpatient Schizophrenia Patients

Jhin Goo Chang,Daeyoung Roh,김찬형 대한정신약물학회 2019 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.17 No.2

Objective: Although various clinical factors that affect medication adherence in schizophrenia have been studied, the role of the therapeutic alliance has not been studied in detail. Accordingly, we investigated the association between medication adherence and therapeutic alliance in patients with schizophrenia treated in a community outpatient clinic in Korea. Methods: In this cross-sectional study, 81 outpatients who met the DSM-IV-TR criteria for schizophrenia were analyzed. Therapeutic alliance was measured via patient-self-report questionnaires consisting of 12 questions, which evaluate both “affective bond” and “collaborative bond” of alliance. We investigated the relationship between medication adherence and therapeutic alliance through correlation and regression analyses. Results: Overall therapeutic alliance was weakly associated with medication adherence (r=0.268, p<0.05). Among two factors of therapeutic alliance, “affective bond” was associated with adherence (r=0.302, p<0.05), but collaborative was not. Regression analysis showed that therapeutic alliance significantly predicted medication adherence even after adjustment for duration of treatment, insight, and symptom severity. Conclusion: Maintaining a favorable therapeutic alliance is associated with medication adherence in schizophrenia. Further, treating patients in a frank and genuine manner might be important to improve adherence.

Neuroablative Intervention for Refractory Obsessive-Compulsive Disorder

Jhin Goo Chang,Se Joo Kim,Chan-Hyung Kim 대한신경정신의학회 2023 PSYCHIATRY INVESTIGATION Vol.20 No.11

Objective This review aims to investigate the progression of neuroablation, along with documented clinical efficacy and safety, in the management of treatment-resistant obsessive-compulsive disorder (OCD).Methods We searched and compiled clinical research results of neuroablation therapy reported to date. We extracted outcomes related to clinical efficacy, side effects, and surgical complications. Additionally, we summarized key claims and findings.Results Neuroablative intervention is a potential treatment approach for refractory OCD. Recent advancements, such as real-time magnetic resonance monitoring and minimally invasive techniques employing ultrasound and laser, offer distinct advantages in terms of safety and comparative efficacy when compared to conventional methods. However, the absence of randomized controlled trials and long-term outcome data underscores the need for cautious consideration when selecting neuroablation.Conclusion Neuroablative intervention shows promise for refractory OCD, but vigilant consideration is essential in both patient selection and surgical method choices due to the potential for rare yet serious complications.

Lethality-Associated Factors in Deliberate Self-Poisoning

In Young Choi,Sun-Young Kim,Jhin Goo Chang,Hoo Rim Song,Woo Jung Kim,Su Young Lee,Hyun-Soo Kim,Minha Hong 대한소아청소년정신의학회 2021 소아청소년정신의학 Vol.32 No.1

Objectives: Deliberate self-poisoning (DSP) is the most common suicide method and can be life-threatening. The purpose of this study was to investigate the factors related to the lethality of DSP and the characteristics of the adolescent group. Methods: A retrospective study was conducted on patients who had visited an academic hospital’s regional emergency medical center between 2015 and 2018. The data reviewed through their medical records included sociodemographic factors, clinical variables, and psychiatric treatment. Four groups (Q1–Q4) were categorized by descriptive analysis using the risk-rescue rating scale. Results: A total of 491 patients were enrolled in this study. This study showed that high lethality had statistically significant associations with male sex, older age, admitting suicidal intentions, and the use of herbicides for suicide. Logistic regression analyses showed a significant association between high-lethality and female [odds ratio (OR)=0.50, 95% confidence interval (CI)=0.30–0.81, p=0.01], non-psychiatric drugs (over-the-counter drug: OR=2.49, 95% CI=1.08–5.74, p=0.03; herbicide: OR=8.65, 95% CI=3.91–19.13, p<0.01), and denial of suicide intent (OR=0.28, 95% CI=0.15–0.55, p<0.01). Conclusion: This study showed the clinical factors associated with the high lethality of DSP and suggested that efforts were needed to care for and thoroughly examine patients with DSP.

소년원생들의 우울증 예측에 기계학습을 적용한 예비연구

손동훈(Dong Hun Son),장진구(Jhin Goo Chang),송후림(Hoo Rim Song),이수영(Su Young Lee),이승훈(Seung Hoon Lee),방수영(Soo-Young Bhang),이미선(Mi-Sun Lee),김현수(Hyun-Soo Kim),홍민하(Minha Hong) 대한사회정신의학회 2021 사회정신의학 Vol.26 No.2

연구목적 : 청소년 범죄에서 정신건강의 문제와 범죄가 관련성이 높다는 것은 잘 알려져 있지만 국내에서는 아동청소년 범죄자들의 정신건강에 관한 연구가 거의 없다. 뿐만 아니라 아동청소년정신건강 영역에서 기계학습을 적용한 연구는 아직 초기단계이다. 본 예비연구에 서는 여자청소년 재소자들에서 정신건강 문제 중 우울증의 예측에 기계학습 알고리즘을 적용하여 적합한 지를 알아보고자 한다. 방 법 : 대상자는 청주소년원에 재소중인 87명의 여자청소년을 대상으로 하였다. 대상자들에게 설문지 패키지 (인구학적 정보, 범죄관련 정보, 자기보고척도 설문지(아동기부정적경험 설문지, 벡우울척도)를 배부하여 정보를 수집하였다. 기계학습 기법을 이용하여 수집된 재소자들의 기본 정보를 바탕으로 우울증을 예측할 수 있는 6개의 모델(Logistic regression, Random forest, Supportive vector machine, Decision tree, Nearest neighbor, Adaboost)을 생성하여 각 모델간의 예측 성능을 비교해 보았다. 결 과 : 대상자를 벡우울척도(절단점 13)로 군을 분류한 결과 정상군 18명(21%)과 우울증군 69명(79%)이었다. 6개 모델의 우울증 예측 정확도는 Logistic regression 81.8%, Random forest 81.8%, Supportive vector machine 68.18%, Decision tree 72.7%, Nearest neighbor 77.3%, Adaboost 63.6%였다. 그중에서 Random forest 모델의 AUC score는 0.75로 다른 모델들과 비교하여 가장 높았다. 결 론 : 본 연구는 재소청소년의 정신건강에 중점을 두어 현황을 파악하고,우울증의 예측에 기계학습 기법을 적용을 하여 높은 정확도를 확인하였다는 점에서 의의가 있다. 또한 취약계층의 정신건강 영역에 기계학습 기법을 적용하여 관리 및 감시에 적용 가능성에 대한 근거를 제공하였다. Objectives : It is well known that mental health problems and crime are highly related to youth crime, but there is little research on the mental health of young offenders in Korea. Furthermore, research on the application of machine learning in the mental health of children and adolescents is still novel. This preliminary study aims to investigate whether it is appropriate to apply machine learning algorithms to predict depression among female adolescent inmates. Methods : The subjects were 87 young females in Cheongju Juvenile Center. A questionnaire was distributed to the subjects to gather their demographic information and crime-related information, as well as their adverse childhood experiences and Beck depression inventory scores using self-reported scale questionnaires. Based on the collected information, six models (logistic regression, random forest, supportive vector machine, decision tree, nearest neighbor, Adaboost) that can predict depression were created to compare the predictive performance between models using machine learning techniques. Results : Results showed that 29 victims (25.7%) met the criteria of PTSD and 19 victims (16.8%) met the rigid criteria of PTSD. But, according to the subscales, 41 victims (36.3%) were diagnosed as PTSD. Victims with PTSD had more serious depression, anxiety, sleep disturbance, anger, social withdrawal and life stresses. Conclusion : This study identified the current mental health status of female inmates with high accuracy by applying machine learn-ing techniques to predict depression. The applicability of machine learning techniques to the management and surveillance of mental health in vulnerable groups was also highlighted.

The Differences in Sleep Skills between Insomnia Patients with and without Need of Hypnotics

Kong Byunghoon,Ko Mi Ae,Chang Jhin Goo,Hong Minha,김우정,Lee Su Young,Kim Hyun Soo,Song Hoo Rim 대한수면학회 2020 sleep medicine research Vol.11 No.2

Background and ObjectiveaaHypnotics are widely prescribed for the treatment of insomnia; however, cognitive behavioral therapy for insomnia (CBT-I) is considered as a primary treatment. We checked ordinary sleep skills of insomnia patients and changes in sleep skills after CBT-I, and evaluated the difference in sleep skills between patients with and without need of hypnotics. MethodsaaA total of 131 outpatients who had visited our sleep clinic with insomnia were recruited. Enrollment criteria included at least 12 weeks of insomnia periods, less than 16 in Beck Depression Inventory score, and agreement to receive 9 sessions of CBT-I for 12 weeks. After 12 weeks of CBT-I, patients were divided into two groups: still in need and no need of hypnotics. Changes in sleep skills were compared between these groups. ResultsaaSleep hygiene, sleep stimulus-control skills, and sleep Visual Analogue Scales (VAS) were statistically improved after CBT-I (all, p < 0.001). Forty-six (35.1%) patients did not need hypnotics anymore; however, 85 (64.9%) still needed hypnotics after CBT-I. Sleep VAS (25.26 ± 8.52 vs. 32.64 ± 8.95, p < 0.001), practicing regular moderate exercise (3.67 ± 0.92 vs. 2.76 ± 1.06, p = 0.030), and having a relaxing bedtime routine (4.08 ± 0.55 vs. 2.76 ± 0.76, p < 0.001) were different in the two groups. ConclusionsaaAmong CBT-I skills, regular moderate exercise and a relaxing bedtime routine seem to be key components. For reducing chronic use of hypnotics, and better outcome of CBT-I, clinicians should focus more on these two components.

한국판 저장행동평가척도의 표준화 연구

이혜민,장진구,송후림,이수영,홍민하,김세주,김찬형,Lee, Hye Min,Chang, Jhin Goo,Song, Hoo Rim,Lee, Soo Young,Hong, Minha,Kim, Se Joo,Kim, Chan-Hyung 대한불안의학회 2021 대한불안의학회지 Vol.17 No.2

Objective : The Hoarding Rating Scale-Self-Report (HRS-SR) is a five-item scale that simply assesses the hoarding symptoms. We evaluated the factor structure, reliability, and validity of the Korean version of the HRS-SR (HRS-SR-K). Methods : A total of 144 individuals completed the self-administered questionnaires including HRS-SR-K, Obsessive-Compulsive Inventory-Revised-Korean version (OCI-R-K), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Psychometric properties of the HRS-SR-K were analyzed. Results : The Cronbach's α value for internal consistency of the HRS-SR-K was excellent (Cronbach's α=0.84). The construct validity was analyzed on the basis of principal component analysis and one-factor structure of the original scale was maintained. The HRS-SR-K total score and each item scores were more strongly correlated with the hoarding subscale score in OCI-R-K (convergent validity, r=0.71, p<0.01) than the corresponding scores of nonspecific depression or anxiety measures (discriminant validity). Conclusion : The HRS-SR-K is a simple and reliable self-report scale for examining the severity of hoarding symptoms.

Quality of Early Depression Management and Long-Term Medical Use: Aspect of Quality Indicators for Outpatients with Depression

Lim Hyun Ho,Lee Jae Kwang,Park Sunyoung,Chang Jhin Goo,Oh Jooyoung,Park Jaesub,Song Jungeun 대한우울조울병학회 2023 우울조울병 Vol.21 No.3

Background: Depression is a global mental health concern that negatively affects individuals’ health and increases medical costs. This study aimed to assess whether early depression management is cost-beneficial and effective from the perspective of quality indicators. Methods: Data of patients newly diagnosed with depressive disorder between 2012 and 2014 as well as follow-up data until 2020 were extracted from the National Health Insurance Service database. Hospitalization, emergency room visits, and annual medical expenses were set as dependent variables to estimate the effect of depression and information on medical expenditures. Six quality indicators developed by the Health Insurance Review and Assessment Service comprised independent variables. Results: In total, 465,766 patients were included in this study. Patients who met the quality indicators were more likely to be hospitalized with a psychiatric diagnosis. Furthermore, patients who met the quality indicator of revisiting within 3 weeks of their first visit had greater psychiatric and overall expenses during the early treatment phase; however, the overall expenses gradually decreased over time. Conclusion: High-quality initial treatment for depression can be cost-effective in the long term; however, further studies are needed to discern its immediate clinical effects.

내시경 점막하 박리법을 시술 받은 위종양 환자에서 심리적 요인이 시술 후 통증에 미치는 영향

이준협,전한호,이산,이혁,오승택,장진구,임우영,박재섭,최원정,Lee, Joon-Hyub,Jeon, Han Ho,Lee, San,Lee, Hyeok,Oh, Seung-Taek,Chang, Jhin Goo,Im, Woo Young,Park, Jaesub,Choi, Won-Jung 한국정신신체의학회 2018 정신신체의학 Vol.26 No.1

연구목적 암 환자에게 있어 통증은 삶의 질과 예후에 큰 영향을 주는 중요한 요소로 통증을 줄이기 위한 시도가 활발히 이루어지고 있다. 이러한 관점에서 위종양 환자에게 많이 시행되는 내시경 점막하 박리법 후 통증을 줄이기 위한 노력이 계속되고 있는데, 시술 후 통증에 영향을 미치는 생물학적 요인이 많이 알려진 것에 비해 심리적 요인에 대해서는 연구가 거의 이루어지지 않았다. 본 연구의 목적은 내시경 점막하 박리법을 시술 받은 위종양 환자가 시술 후 겪는 통증에 영향을 미치는 심리적 요인을 알아보고자 하였다. 방 법 본 연구는 2015년 5월부터 2016년 6월까지 국민건강보험 일산병원에 내원하여 내시경 점막하 박리법을 시술 받은 91명의 위종양 환자를 대상으로 시행되었다. 내시경 점막하 박리법을 시술 받기 전에 사회인구학적 요인과, 불안, 우울, 회복탄력성을 평가하였다. 환자들이 호소하는 통증의 정도가 시각적 유추척도 3점 이상인 군(고통증군)과 3점 미만인 군(저통증군)으로 나누었고, 시술 후 통증에 영향을 주는 요인에 대해 독립표본 T검정 및 카이제곱 검정을 시행 후 유의한 차이를 보인 요인에 대해 로지스틱 회귀분석을 시행하였다. 결 과 고통증군이 저통증군에 비해 음주량이 낮았고 우울 점수가 높게 나타났다. 또한 고통증군이 저통증군에 비해 회복탄력성 점수가 낮았으며, 회복탄력성의 하위 항목 중 자기조절능력, 긍정성 항목에서 점수가 낮았다. 다변량 로지스틱 회귀분석 결과 회복탄력성 중 자기조절능력(OR, 0.911 ; 95% CI, 0.854-0.971, p=0.004)이 낮을수록 내시경 점막하 박리법 시술 후 겪는 통증이 큰 것으로 나타났다. 결 론 본 연구 결과 내시경 점막하 박리법을 시술 받는 환자의 회복탄력성 하위 항목인 자기조절능력이 낮을수록 시술 후 더 큰 통증을 호소하는 것을 확인하였다. 따라서 본 연구에서 대상으로 한 심리적 요인 중 개인의 회복 탄력성이 통증에 영향을 주는 것을 확인하였다. Objectives : Since pain in cancer patients is an important factor that greatly affects the quality of life and prognosis, many attempts have been actively made to reduce the pain. Despite continuous effort on reducing pain after Endoscopic submucosal dissection (ESD), research has not been done on psychological factors as much as on biological factors affecting pain. The objective of this study is to investigate the psychological factors affecting postoperative pain in gastric tumor patients who underwent gastric ESD. Methods : 91 gastric tumor patients who visited National Health Service Ilsan Hospital in Korean between May 2015 and June 2016, and received ESD were evaluated. Baseline characteristics including sociodemographic factors, anxiety, depression, and resilience were evaluated before the procedure. Multivariate logistic regression was done to analyze factors affecting postoperative pain. Results : The group with high postoperative pain showed lower alcohol consumption and higher depressive symptom scores than the group with low postoperative pain. Also, the group with high postoperative pain showed lower total resilience score with lower subtotal scores in self-control and positive item. Multivariate logistic regression analysis of the postoperative pain showed that patients with lower score in self-control of resilience [odd ratio (OR), 0.911 ; 95% CI, 0.854-0.971, p=0.004) reported more pain after ESD. Conclusions : This study showed that patients with lower self-control ability of resilience felt more pain after ESD. Among the psychological factors evaluated in this study, resilience of an individual seems to have effect on pain.

Patient’s Perspective on Psychiatric Drugs: A Multicenter Survey-Based Study

Seoyun Han,Sun-Young Kim,Young-Eun Jung,Won Kim,Jeong Seok Seo,Inki Sohn,Kwanghun Lee,Jong Hun Lee,Sang-Keun Chung,Sang-Yeol Lee,Jung Wan Hong,Bo-Hyun Yoon,Young Sup Woo,Changwoo Han,Jhin Goo Chang,Wo 대한신경정신의학회 2024 PSYCHIATRY INVESTIGATION Vol.21 No.1

Objective We aimed to identify the expectations and preferences for medication and medical decision-making in patients with major psychiatric disorders.Methods A survey was conducted among patients with major psychiatric disorders who visited psychiatric outpatient clinics at 15 hospitals between 2016 and 2018 in Korea. The survey consisted of 12 questions about demographic variables and opinions on their expectations for medication, important medical decision-makers, and preferred drug type. The most preferred value in each category in the total population was identified, and differences in the preference ratio of each item among the disease groups were compared.Results A total of 707 participants were surveyed. In the total population, patients reported high efficacy (44.01%±21.44%) as the main wish for medication, themselves (37.39%±22.57%) and a doctor (35.27%±22.88%) as the main decision makers, and tablet/capsule (36.16%±30.69%) as the preferred type of drug. In the depressive disorders group, the preference ratio of high efficacy was significantly lower, and the preference ratio of a small amount was significantly higher than that of the psychotic disorder and bipolar disorder groups. The preference ratio of a doctor as an important decision maker in the bipolar disorder group was higher compared to the other groups.Conclusion This study revealed the preference for medications and showed differences among patients with psychiatric disorders. Providing personalized medicine that considers a patient’s preference for the drug may contribute to the improvement of drug compliance and outcomes.