Assessing the Sleep-wake Pattern in Cancer Patients for Predicting a Short Sleep Onset Latency

Kikyoung Yi,Joohee Lee,Sungook Yeo,Kyumin Kim,Seockhoon Chung 대한정신약물학회 2022 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.20 No.2

Objective: We investigated the sleep parameters and clinical factors related to short sleep onset latency (SL) in cancer patients. Methods: We retrospectively reviewed the medical records of 235 cancer patients. Patient Health Questionnaire-9, State and Trait Anxiety Inventory (State subcategory), Insomnia Severity Index (ISI), Cancer-related Dysfunctional Beliefs about Sleep, and Fear of Progression scale scores and sleep related parameters including sleeping pill ingestion time, bedtime, sleep onset time, and wake-up time were collected. We also calculated the duration from sleeping pill ingestion to bedtime, sleep onset time, and wake-up time; duration from wake-up time to bedtime and sleep onset time; and time spent in bed over a 24 hours period. Results: Among patients not taking sleeping pills (n = 145), early wake-up time (adjusted odds ratio [OR]: 0.39, 95% confidence interval [CI] 0.19−0.78), early sleep onset time (OR: 0.50, 95% CI 0.27−0.93), and low ISI score (OR: 0.82, 95% CI 0.71−0.93) were identified as expecting variables for SL ≤ 30 minutes. Longer duration from wake-up time to bedtime (OR: 2.49, 95% CI 1.48−4.18) predicted SL ≤ 30 minutes. Among those taking sleeping pills (n = 90), early sleep onset time (OR: 0.54, 95% CI 0.39−0.76) and short duration from pill ingestion to sleep onset time (OR: 0.05, 95% CI 0.02−0.16) predicted SL ≤ 30 minutes. Conclusion: Cancer patients who fell asleep quickly spent less time in bed during the day. Thus, before cancer patients with insomnia are prescribed sleeping pills, their sleep parameters should be examined to improve their SL.

음악을 하는 세 청년에게서 관찰된 공황발작의 의미

이기경 ( Kikyoung Yi ) 한국분석심리학회 2022 心性硏究 Vol.37 No.1

이 글은 음악을 하는 20대 초반 청년들에게 발생한 공황발작의 의미를 분석심리학적으로 이해해보고자 하는 시도이다. 공황발작은 주로 20대에 발생한다고 알려진 불안신경증의 일종으로 다양한 자율신경계 증상에 동반되는 극심한 공포와 두려움이 특징이다. 공황발작과 감정기복, 자살사고나 자해행동이 동반된 세 사례에서 공황발작이 나타났던 상황을 살펴보고, 각 사례에서 공황발작의 심리적 의미를 살펴보았다. 첫 번째 사례의 공황발작은 무의식적인 상태로 남아 있고자 하는 이에게 의식성을 가지고 생각하거나 사고하게끔 한다. 두 번째 사례에서 미래를 향한 삶으로의 전진을 망설이며 갈등하는 이에게 내면의 문을 열어 자신의 깊은 마음과 접촉할 수 있게 하여 갈등을 초월할 가능성을 열어주기도 한다. 세 번째 사례에서는 무의식의 실현되고자 하는 본능과 충동을 공황발작으로 경험하고, 그 충동을 의식적으로 실현해간다. 각각 다른 의미가 있는 것처럼 보이는 그들의 공황발작은 청년기 이전 시기의 의식 수준으로부터 새로워질 것을 촉구하는 무의식의 강력한 접근일 것이다. This text is an attempt to understand the psychological meaning of panic attacks occurring in the young people in their early twenties who play music. A panic attack is a type of anxiety neurosis known to occur primarily in their twenties and is characterized by extreme fear and terror accompanied by various symptoms in the autonomic nervous system. Situations with occurring panic attacks were examined in three cases combined with panic attacks and mood swings, suicidal ideation, and self-mutilating behaviors, and the psychological meaning of panic attacks was reviewed for each case. In the first case, panic attacks make one think or reflect with consciousness for someone who wants to remain unconscious. In the second case, for one who hesitates to move forward in life and finds oneself in conflict, panic attacks open the inner mind and allow one to come in touch with one’s deeper mind, thereby opening possibilities to transcend the conflict. In the third case, one experience the instinct and impulse of desiring to realize the unconsciousness as panic attacks and thereafter consciously realize the impulse as well. Their panic attacks, which all seem to have different meanings, are likely a powerful approach of the unconsciousness to urge a renewal from the consciousness level of the youth period.

Dysfunctional Beliefs about Sleep in Cancer Patients Can Mediate the Effect of Fear of Progression on Insomnia

Insoo Kim,Kikyoung Yi,이주희,Kyumin Kim,Soyoung Youn,서수연,Jiyeon Kim,Jung mun choi,정석훈 대한수면학회 2019 sleep medicine research Vol.10 No.2

Sleep Med Res > Volume 10(2); 2019 > Article Original Article Sleep Medicine Research (SMR) 2019; 10(2): 83-89. Published online: Dec 31, 2019 DOI: https://doi.org/10.17241/smr.2019.00451 Dysfunctional Beliefs about Sleep in Cancer Patients Can Mediate the Effect of Fear of Progression on Insomnia Insoo Kim, MD1, Kikyoung Yi, MD2, Joohee Lee, MD1, Kyumin Kim, MD1, Soyoung Youn, MD1, Sooyeon Suh, PhD3, Jiyeon Kim, PhD4, Jung Mun Choi, BA1, Seockhoon Chung, MD, PhD1 1Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 2Department of Psychiatry, Yongin Mental Health, Yongin, Korea 3Department of Psychology, Sungshin Women’s University, Seoul, Korea 4Department of Art Therapy, Hanyang Cyber University, Seoul, Korea Correspondence: Seockhoon Chung, MD, PhD, Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 86 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea, Tel +82-2-3010-3411, Fax +82-2-485-8381, E-mail schung@amc.seoul.kr Received Oct 21, 2019 Revised Nov 1, 2019 Accepted Nov 5, 2019 Copyright© 2019 The Korean Society of Sleep Medicine Abstract Background and Objective The role of the dysfunctional belief about sleep is important for the development of insomnia among cancer patients. This study intended to investigate whether dysfunctional belief about sleep mediates the relationship between fear of progression and insomnia in cancer patients. Methods Three hundred and thirty-seven cancer patients participated in our study. Dysfunctional belief about sleep, severity of insomnia, depression, fear of progression, and anxiety were measured using the following questionnaires: Cancer-related Dysfunctional Beliefs about Sleep (C-DBS); Insomnia Severity Index (ISI); Patient Health Questionnaire-9 (PHQ-9); Fear of Progression (FoP); and the state subcategory of State and Trait Anxiety Inventory (STAI). Path analysis was used to clarify the relationships among the variables. Since C-DBS consists of two items, i.e., Q1-immune & Q2-recurrence, we implemented an additional path analysis including these variables separately. Results C-DBS mediated the effect of FoP (β = 0.36, p < 0.001) and patient sex (β = 0.13, p = 0.009) on ISI. PHQ-9 (β = 0.32, p < 0.001) and STAI (β = -0.09, p = 0.071) had a direct influence on ISI scores. In our second path analysis, Q1-immune item mediated the effect of FoP (β = 0.19, p < 0.001) on ISI, and Q2-recurrence item mediated the effect of FoP (β = 0.23, p < 0.001) and patient sex (β = 0.09, p = 0.019) on ISI. Conclusions Our path analysis model indicated that C-DBS mediates the effect of FoP and patient sex on ISI. Our second path analysis results suggested that there could be an internal process of Q1 and Q2 item. Efforts to reduce dysfunctional beliefs should be considered as well as management of fear of progression for better sleep of cancer patients.

No Association Between Insomnia Severity, and Discrepancy Between Desired Time in Bed and Desired Total Sleep Time Among Shift-Working Nursing Professionals

Bzeih Wafaa,Kim Sohyeong,Yi Kikyoung,Chung Seockhoon 대한수면학회 2023 sleep medicine research Vol.14 No.3

Background and Objective This study aimed to explore whether the discrepancy between a patient’s desired time in bed and desired total sleep time (DBST index) can be used as a tool to assess the insomnia severity of shift-working nursing professionals.Methods Two studies were conducted during two different times among two groups of shiftworking nursing professionals working in COVID-19 inpatient wards (study I), or nurses who witnessed patient death during the previous 2 years (study II), using a single voluntary survey. The survey was completed by a total of 366 participants: 226 in the first study, and 140 in the second. Participants’ age, sex, marital status, and past psychiatric history were collected. In addition to questions regarding the DBST index, the Glasgow Sleep Effort Scale (GSES), Dysfunctional Beliefs about Sleep-2 items (DBS-2), and the Insomnia Severity Index (ISI) were assessed.Results In both studies, the DBST index did not reflect insomnia severity, preoccupation with sleep, or dysfunctional beliefs about sleep in the linear regression analysis. In addition, ISI was expected by GSES (β = 0.67 in study I, β = 0.62 in study II, all p < 0.001) and DBS-2 (β = 0.16 in study II, p = 0.020), but not by the DBST index.Conclusions It was observed that the DBST index was not significantly associated with insomnia severity, preoccupation with sleep, or dysfunctional beliefs about sleep in two studies done among shift working-nursing professionals.

2006-2011년의 한국의 자살생각률, 자살시도율, 자살사망률의 추세

이기경,나리지,안명희,임아영,홍진표,Yi, Kikyoung,Na, Ri Ji,Ahn, Myung Hee,Lim, Ahyoung,Hong, Jin Pyo 대한불안의학회 2012 대한불안의학회지 Vol.8 No.2

Objective : The purpose of this study was to describe and compare trends in suicidal ideation, suicidal attempt and suicide in Republic of Korea from 2006 to 2011. Such data are needed to guide policies to reduce suicidal behaviors. Methods : Data came from the 2006-2010 Korea National Health and Nutrition Examination Survey, Korea National Statistical Office and 2006-2011 Korean Epidemiologic Catchment Area Study Replication and 2007-2011 National Emergency Department Information System. Results : No change occurred between 2006-2011 in suicidal ideation, suicidal attempt, whereas suicide rate increased annually. Suicidal attempt events was decreased in age over 50. Suicidal attempts by poisoning and hanging have increased, although suicide caused by poisoning of insecticide have decreased. Especially, suicides caused by hanging have gradually increased in both sex. Conclusions : These finding suggest that fatal suicidal methods may influence increased suicidal rate. Instead of traditional suicidal process, investigation of other pathway about suicidal behaviors should be needed.

Trends in Suicide Methods and Rates among Older Adults in South Korea: A Comparison with Japan

박수빈,Hochang Benjamin Lee,Su Yeon Lee,Go Eun Lee,Myung Hee Ahn,Kikyoung Yi,Jin Pyo Hong 대한신경정신의학회 2016 PSYCHIATRY INVESTIGATION Vol.13 No.2

ObjectiveaaLethality of the chosen method during a suicide attempt is a strong risk factor for completion of suicide. We examined whether annual changes in the pattern of suicide methods is related to annual changes in suicide rates among older adults in South Korea and Japan. MethodsaaWe analyzed annual the World Health Organization data on rates and methods of suicide from 2000 to 2011 in South Korea and Japan. ResultsaaFor Korean older adults, there was a significant positive correlation between suicide rate and the rate of hanging or the rate of jumping, and a significant negative correlation between suicide rate and the rate of poisoning. Among older adults in Japan, annual changes in the suicide rate and the pattern of suicide methods were less conspicuous, and no correlation was found between them. ConclusionaaThe results of the present study suggest that the increasing use of lethal suicide methods has contributed to the rise in suicide rates among older adults in South Korea. Targeted efforts to reduce the social acceptability and accessibility of lethal suicide methods might lead to lower suicide rate among older adults in South Korea.

Discrepancy Between Desired Time in Bed and Desired Total Sleep Time, Insomnia, Depression, and Dysfunctional Beliefs About Sleep Among the General Population

Lee Joohee,Cho Inn-Kyu,Kim Kyumin,Kim Changnam,Park C. Hyung Keun,Yi Kikyoung,Chung Seockhoon 대한신경정신의학회 2022 PSYCHIATRY INVESTIGATION Vol.19 No.4

Objective The aim of this study was to explore the factors that can influence the severity of insomnia in the general population. We also aimed to examine whether sleep effort mediates the association between dysfunctional beliefs about sleep or the discrepancy between desired time in bed and desired total sleep time (DBST) and insomnia severity in individuals.Methods A total of 387 participants enrolled in this e-survey study. The symptoms were rated using the insomnia severity index (ISI), Patients Health Questionnaire-9 items, Dysfunctional Beliefs about Sleep-2 items, Glasgow Sleep Effort Scale, and Stress and Anxiety to Viral Epidemics-6 items. In addition, we defined a new sleep index named the DBST index. A linear regression analysis was performed to explore the factors predicting ISI scores, and mediation analysis was implemented to explore whether persistent preoccupation with sleep mediated the influence of dysfunctional beliefs about sleep and DBST on insomnia severity.Results A linear regression analysis investigated depression (β=0.17, p<0.001), sleep effort (β=0.50, p<0.001), dysfunctional beliefs about sleep (β=0.13, p=0.001), and DBST (β=0.09, p=0.014) (adjusted R<i>2</i>=0.50, F=65.7, p<0.001). Additionally, we observed that persistent preoccupation with sleep partially mediated the influence of dysfunctional beliefs about sleep and DBST on insomnia severity. Conclusion Depression, preoccupation with sleep, dysfunctional beliefs about sleep, and DBST influenced the insomnia severity of the general population. We also observed that a persistent preoccupation with sleep partially mediated the influence of dysfunctional beliefs about sleep and the DBST index on insomnia severity.Conclusion Depression, preoccupation with sleep, dysfunctional beliefs about sleep, and DBST influenced the insomnia severity of the general population. We also observed that a persistent preoccupation with sleep partially mediated the influence of dysfunctional beliefs about sleep and the DBST index on insomnia severity.