Regional Gray Matter Volume Related to High Occupational Stress in Firefighters

Lee Deokjong,Kim Woojin,Lee Jung Eun,Lee Junghan,Lee Seung-Koo,Chang Sei-Jin,Jeung Da Yee,Hyun Dae-Sung,Ryu Hye-Yoon,Kim Changsoo,Jung Young-Chul 대한의학회 2021 Journal of Korean medical science Vol.36 No.50

Background: Firefighters inevitably encounter emotionally and physically stressful situations at work. Even firefighters without diagnosed post-traumatic stress disorder receive clinical attention because the nature of the profession exposes them to repetitive trauma and high occupational stress. This study investigated gray matter abnormalities related to high occupational stress in firefighters using voxel-based morphometry (VBM) and surface-based morphometry (SBM). Methods: We assessed 115 subjects (112 males and 3 females) using magnetic resonance imaging and evaluated occupational stress by the Korean Occupational Stress Scale-26 (KOSS-26). Subjects were classified into highly or lowly stressed groups based on the median value of the KOSS-26. Results: In VBM analysis, we found that firefighters with high occupational stress had lower gray matter volume (GMV) in both sides of the insula, the left amygdala, the right medial prefrontal cortex (mPFC), and the anterior cingulate cortex than firefighters with low occupational stress. In SBM analysis based on regions of interest, the GMV of the bilateral insula and right mPFC were also lower in the highly stressed group. Within the highly stressed group, low GMV of the insula was significantly correlated with the length of service (left: r = −0.347, P = 0.009; right: r = −0.333, P = 0.012). Conclusion: Our findings suggest that regional GMV abnormalities are related to occupational stress. Regional gray matter abnormalities and related emotional dysregulation may contribute to firefighter susceptibility to burnout.

Altered functional connectivity in default mode network in Internet gaming disorder: Influence of childhood ADHD

Lee, Deokjong,Lee, Junghan,Lee, Jung Eun,Jung, Young-Chul Elsevier 2017 Progress in neuro-psychopharmacology & biological Vol.75 No.-

<P><B>Abstract</B></P> <P><B>Objective</B></P> <P>Internet gaming disorder (IGD) is a type of behavioral addiction characterized by abnormal executive control, leading to loss of control over excessive gaming. Attention deficit and hyperactivity disorder (ADHD) is one of the most common comorbid disorders in IGD, involving delayed development of the executive control system, which could predispose individuals to gaming addiction. We investigated the influence of childhood ADHD on neural network features of IGD.</P> <P><B>Methods</B></P> <P>Resting-state functional magnetic resonance imaging analysis was performed on 44 young, male IGD subjects with and without childhood ADHD and 19 age-matched, healthy male controls. Posterior cingulate cortex (PCC)-seeded connectivity was evaluated to assess abnormalities in default mode network (DMN) connectivity, which is associated with deficits in executive control.</P> <P><B>Results</B></P> <P>IGD subjects without childhood ADHD showed expanded functional connectivity (FC) between DMN-related regions (PCC, medial prefrontal cortex, thalamus) compared with controls. These subjects also exhibited expanded FC between the PCC and brain regions implicated in salience processing (anterior insula, orbitofrontal cortex) compared with IGD subjects with childhood ADHD. IGD subjects with childhood ADHD showed expanded FC between the PCC and cerebellum (crus II), a region involved in executive control. The strength of connectivity between the PCC and cerebellum (crus II) was positively correlated with self-reporting scales reflecting impulsiveness.</P> <P><B>Conclusion</B></P> <P>Individuals with IGD showed altered PCC-based FC, the characteristics of which might be dependent upon history of childhood ADHD. Our findings suggest that altered neural networks for executive control in ADHD would be a predisposition for developing IGD.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Hypothesis about causal factors of internet gaming disorder is proposed. </LI> <LI> Internet gaming disorder shows altered functional connectivity in default mode network. </LI> <LI> Internet gaming disorder with childhood ADHD shows altered functional connectivity associated with executive control deficit. </LI> </UL> </P>

Lipidomic profiles disturbed by the internet gaming disorder in young Korean males

Lee, Chang-Wan,Lee, Deokjong,Lee, Eun Mi,Park, Soo Jin,Ji, Dong Yoon,Lee, Do Yup,Jung, Young-Chul Elsevier 2019 Journal of chromatography. B, Analytical technolog Vol.1114 No.-

<P><B>Abstract</B></P> <P>Internet Gaming Disorder (IGD) is characterized by uncontrollable and persistent playing of internet games despite the occurrence of negative consequences. Although there is a worldwide treatment demand, IGD still doesn't have an explicit biomarker.</P> <P>The primary goal of the study is to characterize lipidomic profiles specific to internet gaming disorder (IGD) based on liquid-chromatography Orbitrap mass-spectrometry (LC Orbitrap MS). Primarily, a total of 19 lipids were significantly dys-regulated in the IGD group compared to healthy controls. The lipidomic feature was mainly characterized by various types of phosphatidylcholines (PCs) and lyso-phosphatidylcholines (LysoPCs). Subsequent multivariate statistical model and linear regression model prioritized two LysoPCs (C16:0 and C18:0) for potential biomarker. Receiver operating characteristic (ROC) analysis demonstrated excellent performance of the combined lipid set for discriminating the IGD group from healthy controls (AUC: 0.981, 95% confidence interval: 0.958–1.000). Additional evaluation with potential confounders and clinical parameters suggested robustness and potential applicability of the outcome as biomarkers which may aid diagnosis.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Lipid profiles revealed lipid metabolism dys-regulation by internet gaming disorder. </LI> <LI> Discovery of biomarker cluster in combination with LysoPC 16:0 and LysoPC 18:0 </LI> <LI> Validation of biomarker recomposite by evaluation of potential confounding effects. </LI> </UL> </P>

Impaired anterior insular activation during risky decision making in young adults with internet gaming disorder

Lee, Deokjong,Lee, Junghan,Yoon, Kang Joon,Kee, Namkoong,Jung, Young-Chul Wolters Kluwer Health | Lippincott Williams Wilkin 2016 NEUROREPORT - Vol.27 No.8

<P>Internet gaming disorder is defined as excessive and compulsive use of the internet to engage in games that leads to clinically significant psychosocial impairment. We tested the hypothesis that individuals with internet gaming disorder would be less sensitive to high-risk situations and show aberrant brain activation related to risk prediction processing. Young adults with internet gaming disorder underwent functional MRI while performing a risky decision-making task. The healthy control group showed stronger activations within the dorsal attention network and the anterior insular cortex, which were not found in the internet gaming disorder group. Our findings imply that young adults with internet gaming disorder show impaired anterior insular activation during risky decision making, which might make them vulnerable when they need to adapt new behavioral strategies in high-risk situations. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.</P>

Gray matter differences in the anterior cingulate and orbitofrontal cortex of young adults with Internet gaming disorder: Surface-based morphometry

Lee, Deokjong,Park, Jinsick,Namkoong, Kee,Kim, In Young,Jung, Young-Chul Akadémiai Kiadó 2018 JOURNAL OF BEHAVIOURAL ADDICTIONS Vol.7 No.1

<P><B>Background and aims</B></P><P>Altered risk/reward decision-making is suggested to predispose individuals with Internet gaming disorder (IGD) to pursue short-term pleasure, despite long-term negative consequences. The anterior cingulate cortex (ACC) and the orbitofrontal cortex (OFC) play important roles in risk/reward decision-making. This study investigated gray matter differences in the ACC and OFC of young adults with and without IGD using surface-based morphometry (SBM).</P><P><B>Methods</B></P><P>We examined 45 young male adults with IGD and 35 age-matched male controls. We performed region of interest (ROI)-based analyses for cortical thickness and gray matter volume (GMV) in the ACC and OFC. We also conducted whole-brain vertex-wise analysis of cortical thickness to complement the ROI-based analysis.</P><P><B>Results</B></P><P>IGD subjects had thinner cortices in the right rostral ACC, right lateral OFC, and left pars orbitalis than controls. We also found smaller GMV in the right caudal ACC and left pars orbitalis in IGD subjects. Thinner cortex of the right lateral OFC in IGD subjects correlated with higher cognitive impulsivity. Whole-brain analysis in IGD subjects revealed thinner cortex in the right supplementary motor area, left frontal eye field, superior parietal lobule, and posterior cingulate cortex.</P><P><B>Conclusions</B></P><P>Individuals with IGD had a thinner cortex and a smaller GMV in the ACC and OFC, which are critical areas for evaluating reward values, error processing, and adjusting behavior. In addition, in behavioral control-related brain regions, including frontoparietal areas, they also had thinner cortices. These gray matter differences may contribute to IGD pathophysiology through altered risk/reward decision-making and diminished behavioral control.</P>

Exploratory metabolomics of biomarker identification for the internet gaming disorder in young Korean males

Cho, Yeo Ul,Lee, Deokjong,Lee, Jung-Eun,Kim, Kyoung Heon,Lee, Do Yup,Jung, Young-Chul Elsevier 2017 Journal of chromatography. B, Analytical technolog Vol.1057 No.-

<P><B>Abstract</B></P> <P>The main aim of the current research is to characterize the molecular dynamics related to internet gaming disorder (IGD) using non-targeted plasma metabolite profiling based on gas-chromatography time-of-flight mass spectrometry (GC-TOF MS). IGD is a psychiatric disorder instigated by excessive and prolonged internet gaming, which shared many pathological symptoms with attention deficit hyperactivity disorder (ADHD). The prevalence of the disorder has been rapidly increased particularly in East Asia countries (5.9% in South Korea) compared to Europe or North America (0.3–1.0% in United States and 1.16% in Germany). Thus we comparably explored the correlation between plasma metabolites and internet addiction severity in IGD patients, and potential biomarker composite in combination with clinical parameters. The systematic metabolite profiling of 54 blood samples (normal user, <I>N</I> =28 and IGD, <I>N</I> =24) identified a total of 104 metabolites out of 1212 metabolic feature, and revealed unique relation of co-linearly regressed set of plasma metabolites (arabitol, <I>myo</I>-inositol, methionine, pyrrole-2-carboxylic acid, and aspartic acid) with internet addiction severity scale (R=0.795). In addition, orthogonal partial least squared discriminant analysis (OPLS-DA) and receiver operating characteristic (ROC) analysis identified the potential biomarker cluster that simultaneously discriminated the different types of the psychiatric status. The potential biomarker re-composite was comprehensively evaluated by a receiver operating characteristic (ROC) analysis where the AUCs were 0.890, 0.880, 1.000, and 0.935 for control, IGD, AD and IGD+AD, respectively (<I>N</I> =18, 19, 5, and 10) against the others. This exploratory method may provide robustness of predictive diagnosis in population screening of IGD. The identified metabolic features, the relatedness with clinical parameters, and the putative biochemical linkage will hopefully aid future pathological studies in IGD.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Atypical blood metabolite levels may reflect abnormal homeostasis in internet gaming disorder (IGD). </LI> <LI> Multiple logistic regression model suggested significant association between plasma metabolites and internet addiction severity. </LI> <LI> Potential biomarker cluster simultaneously discriminated different psychiatric status in combination of metabolites and clinical characteristics. </LI> <LI> Among them were arabitol, <I>myo</I>-inositol, methionine, and depression that were the unique predictors for IGD group. </LI> </UL> </P>

Association between childhood and adult attention deficit hyperactivity disorder symptoms in Korean young adults with Internet addiction

Kim, DongIll,Lee, Deokjong,Lee, Junghan,Namkoong, Kee,Jung, Young-Chul Akadémiai Kiadó 2017 Journal of behavioral addictions Vol.6 No.3

<P><B>Background and aims</B></P><P>Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric comorbidities of Internet addiction (IA); however, the possible mechanisms that contribute to this high comorbidity are still under debate. This study aims to analyze these possible mechanisms by comparing the effect of IA severity and childhood ADHD on inattention, hyperactivity, and impulsivity in young adults with IA. We hypothesized that IA might have associations with ADHD-like cognitive and behavior symptoms aside from childhood ADHD.</P><P><B>Methods</B></P><P>Study participants consisted of 61 young male adults. Participants were administered a structured interview. The severity of IA, childhood and current ADHD symptoms, and psychiatry comorbid symptoms were assessed through self-rating scales. The associations between the severity of IA and ADHD symptoms were examined through hierarchical regression analyses.</P><P><B>Results</B></P><P>Hierarchical regression analyses showed that the severity of IA significantly predicted most dimensions of ADHD symptoms. By contrast, childhood ADHD predicted only one dimension.</P><P><B>Discussion</B></P><P>The high comorbidity of inattention and hyperactivity symptoms in IA should not solely be accounted by an independent ADHD disorder but should consider the possibility of cognitive symptoms related to IA. Functional and structural brain abnormalities associated with excessive and pathologic Internet usage might be related to these ADHD-like symptoms.</P><P><B>Conclusion</B></P><P>Inattention and hyperactivity in young adults with IA are more significantly associated with the severity of IA than that of childhood ADHD.</P>

인터넷 중독 및 스마트폰중독이 있는 젊은 남자 성인에서의 공존 정신병리

김동일(Dongill Kim),이덕종(Deokjong Lee),김진경(Jin Kyoung Kim),성고은(Goeun Seong),정영철(Young-Chul Jung) 한국중독정신의학회 2017 중독정신의학 Vol.21 No.2

Objectives : Young adults with internet addiction and smartphone addiction have a high prevalence of psychiatric comorbidity ; however, the possible differences between digital devices-desktop PC vs. smartphone-are still under debate. Methods : Participants were 148 young male adults (mean age=23.8±2.3 years). They were divided into the following four groups: General user group, Internet addiction group, Smartphone addiction group, and Dual addiction group. In order to assess the difference between devices, internet addiction severity was evaluated only based on the activity using desktop personal computers. The comorbid psychopathology-depression, anxiety, alcohol use-related symptoms, adult ADHD symtpoms (i.e., inattention, hyperactivity, impulsivity), childhood ADHD symptoms -was assessed by using self-report scales. Results : On comparing the prevalence of comorbid psychopathology among the four groups, 66.9% of patients in the Internet addiction group, 41.7% of patients in the Smartphone addiction group, and 59.6% of patients in the Dual addiction group had at least one comorbid psychopathology. Compared to the smartphone addiction group, the internet addiction group showed higher levels of comorbid depression and adult ADHD psychopathology. Internet addiction severity correlated with childhood ADHD, depression and anxiety. In contrast, smartphone addiction severity correlated with childhood ADHD and anxiety. Conclusion : Our results showed that internet addiction and smartphone addiction have different comorbid psychopathologies

Mental Health Problems During COVID-19 and Attitudes Toward Digital Therapeutics

Manjae Kwon,Young-Chul Jung,Deokjong Lee,Jaeun Ahn 대한신경정신의학회 2023 PSYCHIATRY INVESTIGATION Vol.20 No.1

Objective We aimed to elucidate public mental health problems and associated factors during the coronavirus disease-2019 (COVID-19). Furthermore, we evaluated people’s attitudes toward digital therapeutics during the pandemic. Methods Data was collected online from participants, aged between 20–50 without any history of mental illness, from June 1st to June 30th 2021. The survey consisted of questions regarding demographics, changes during pandemic and attitude towards digital therapeutics, and mental health measures. Results Among the total of 445 participants, 49.2% reported significant level of stress and 13.5% and 7.0% met the screening criteria for major depressive disorder and generalized anxiety disorder, respectively. Significant predictive factors for mental health problems were-younger age group, female sex, currently being treated for medical or surgical disease, change in the amount of time spent on mobile device or computer after pandemic, change in household income, and change in work environment due to pandemic. Furthermore, 35.1% of participants, considered psychiatric consultation, at least slightly, but were hesitant to receive it due to the fear of contacting COVID-19 at the clinics. Instead, 54.4% of them preferred using digital therapeutics as an alternative to visiting offline clinics. Conclusion We demonstrated that COVID-19 increased mental health problems along with access problems and identified their predictive factors. Digital therapeutics emerged as a viable solution to mental health problems and it was well-received by those in need of psychiatric consultation. Therefore, development and implementation of digital therapeutics should be considered to improve the mental health of people.

인터넷 게임장애 및 알코올 사용장애 환자의 하두정소엽 회백질 부피 변화

최항녕(Hangnyoung Choi),정영철(Young-Chul Jung),이덕종(Deokjong Lee) 한국중독정신의학회 2020 중독정신의학 Vol.24 No.2

Objectives : The purpose of the present study was to conduct a comparison of structural brain alterations between people with Internet gaming disorder (IGD) and alcohol use disorder (AUD) in young males. Methods : Twenty-four young males with IGD, 22 young males with AUD, and 30 healthy control (HC) subjects participated in this study. We applied voxel-based morphometric analysis with diffeomorphic anatomical registration using an exponentiated Lie algebra algorithm. A whole-brain analysis was conducted to investigate the locations of gray matter volume differences between the groups. Results : Both the Individuals with IGD and AUD had significantly smaller gray matter volume in the left inferior parietal lobe than the healthy controls (IGD<HC, p=0.005; AUD<HC, p<0.001). There was no significant difference in gray matter volume in the inferior parietal lobule between the IGD and AUD groups. Conclusion : We demonstrated that IGD and AUD shared structural abnormalities in the inferior parietal lobule. The inferior parietal lobule is involved in the integration between top-down and bottom-up control. The volume of the gray matter in the inferior parietal lobule is known to be highly influenced by genetic factors. The results of this study suggest susceptibility shared between people with IGD and those with AUD.