Effects of Depression and Resilience of Public Workers on Work-related Stress and Anxiety in Response to the COVID-19 Pandemic

Ju Gawon,Lee Jeonghwan,Ahn Myung Hee,Lee Joohee,Kim Eun Jeong,Suh Sooyeon,Chung Seockhoon 대한의학회 2021 Journal of Korean medical science Vol.36 No.36

Background: This study explored the clinical variables related to public workers' stress and anxiety regarding the viral epidemic, and the mediating effect of resilience on the relationship between their depression and anxiety in response to coronavirus disease 2019 (COVID-19) pandemic. Methods: A total of 938 public workers answered anonymous questionnaires in May 2020. The survey included rating scales such as the Stress and Anxiety to Viral Epidemics-9 (SAVE9), Patients Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Connor-Davidson Resilience Scale 2 items (CD-RISC 2), and subjects also answered whether they were employed in COVID-19 related fields. Results: Married, female, junior, public workers reported a higher level of stress and anxiety in response to the viral epidemic. Furthermore, high levels of stress and anxiety toward the epidemic are defined by high PHQ-9, high GAD-7, and low CD-RISC 2 scores. It could also be seen that resilience mediated the effect of depression in public workers and their stress and anxiety levels toward the epidemic. Conclusion: It is important to reduce the psychological burden of public workers and manage their mental health to help them cope with the epidemic wisely and efficiently. Among many mental health factors, psychological resilience represents an essential target for psychological intervention among public workers.

Prevalence of and factors associated with anxiety and depression in Korean patients with newly diagnosed advanced gastrointestinal cancer

( Junghwa Chung ),( Gawon Ju ),( Jiyoul Yang ),( Jiwon Jeong ),( Yusook Jeong ),( Moon Ki Choi ),( Jihyun Kwon ),( Ki Hyeong Lee ),( Seung Taik Kim ),( Hye Sook Han ) 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.3

Background/Aims: The purpose of the present study was to assess the prevalence of and factors associated with anxiety and depression in Korean patients with advanced gastrointestinal cancer. Methods: One hundred and twenty consecutive patients with newly diagnosed, advanced gastrointestinal cancer who were scheduled to receive palliative chemotherapy between July 2012 and June 2014 were enrolled in this observational prospective study. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire-9 (PHQ-9). Results: Thirty-seven patients (30.8%) had anxiety or depression with clinical significance according to HADS or PHQ-9. Multivariate analysis identified lower performance status (odds ratio [OR], 4.19; 95% confidence interval [CI], 1.22 to 14.35; p = 0.023), gastric cancer (OR, 5.39; 95% CI, 0.37 to 78.23; p = 0.018), and knowledge of advanced cancer (OR, 15.07; 95% CI, 1.80 to 125.90; p = 0.012) as significantly associated with anxiety or depression. Twenty-one patients with anxiety or depression visited the psycho-oncologic clinic. In these patients, PHQ-9 score (p = 0.008), global health status (p = 0.023), fatigue (p = 0.047), and appetite loss (p = 0.006) improved from baseline to 3 months after study enrollment. Conclusions: Approximately 30% of Korean patients with advanced gastrointestinal cancer had anxiety or depression. The prevalence of anxiety or depression was higher in patients with poor performance status, gastric cancer, or knowledge of advanced cancer. Psychiatric interventions may be effective in reducing depression and improving quality of life in cancer patients with anxiety or depression.

The Relationship Between Anger and Suicidality

Kim Jun-Hyuck,Ju Gawon,Lee Sang Ick,Shin Chul-Jin,Son Jung-Woo,Kim Siekyeong,Lee Jeonghwan,Chung Seungwon 대한우울조울병학회 2023 우울조울병 Vol.21 No.3

Background: This study explored the effect of anger on suicidality by dividing participants into a group with major depressive disorder (MDD) and a non-MDD group, and also investigated whether the anger expression affects suicidality in participants without clinical depression. Methods: A total of 1,015 residents responded to anonymous questionnaires in our survey. The survey included scales, such as the Patients Health Questionnaire-9 (PHQ-9), Korean State-Trait Anger Expression Inventory, and Mini-International Neuropsychiatric Interview-Plus. Participants were categorized into the MDD and non-MDD groups or depression group and non-depression group following the PHQ-9 score. Logistic regression analysis was performed to confirm the association between anger and suicidality in the non-MDD and non-MDD groups. Results: Anger suppression and higher PHQ-9 appeared as risk factors for suicidality in the non-MDD group. The depression level in the non-MDD group mediates the relationship between anger suppression and suicidality. Higher PHQ-9 was no longer a risk factor and anger suppression remains a risk factor in the non-depression group. Conclusion: Not only depression evaluation, but also anger evaluation is important when assessing suicidality. Implementing anger management programs for people with high anger suppression can help lower suicidality in Korean society, where negative emotional expression is suppressed.

Graph Theoretical Analysis of Brain Structural Connectivity in Patients with Alcohol Dependence

이현정,정준형,정성원,Ju Gawon,김시경,손정우,신철진,이상익,Lee Jeonghwan 한국뇌신경과학회 2023 Experimental Neurobiology Vol.32 No.5

This study aimed to compare brain structural connectivity using graph theory between patients with alcohol dependence and social drinkers. The participants were divided into two groups; the alcohol group (N=23) consisting of patients who had been hospitalized and had abstained from alcohol for at least three months and the control group (N=22) recruited through advertisements and were social drinkers. All participants were evaluated using 3T magnetic resonance imaging. A total of 1000 repeated whole-brain tractographies with random parameters were performed using DSI Studio. Four hundred functionally defined cortical regions of interest (ROIs) were parcellated using FreeSurfer based on the Schaefer Atlas. The ROIs were overlaid on the tractography results to generate 1000 structural connectivity matrices per person, and 1000 matrices were averaged into a single matrix per subject. Graph analysis was performed through igraph R package. Graph measures were compared between the two groups using analysis of covariance, considering the effects of age and smoking pack years. The alcohol group showed lower local efficiency than the control group in the whole-brain (F=5.824, p=0.020), somato-motor (F=5.963, p=0.019), and default mode networks (F=4.422, p=0.042). The alcohol group showed a lower global efficiency (F=5.736, p=0.021) in the control network. The transitivity of the alcohol group in the dorsal attention network was higher than that of the control (F=4.257, p=0.046). Our results imply that structural stability of the whole-brain network is affected in patients with alcohol dependence, which can lead to ineffective information processing in cases of local node failure.

폐쇄성 수면 무호흡증의 심각도와 심박동 변이율 : 탈경향변동분석

주가원,신철진,박두흠,Ju, Gawon,Shin, Chul-Jin,Park, Doo-Heum 대한생물정신의학회 2009 생물정신의학 Vol.16 No.2

Objectives : The detrended fluctuation analysis is one of the nonlinear methods for the investigation of biological time series. It quantifies the fractal scaling properties and is known to be useful in the evaluation of long-range correlations in time series. The heart rate variability(HRV) of obstructive sleep apnea syndrome (OSAS) patients during nighttime was analyzed by detrended fluctuation analysis to assess its relationship with the severity of the symptoms. Methods : Fifty nine untreated male OSAS patients with moderate to severe symptoms(mean age=45.4${\pm}$11.7 years, apnea-hypopnea index, AHI${\geq}$15) underwent nocturnal polysomnography. Moderate(AHI=15-30, N=22) and severe(AHI>30, N=37) OSAS patients were compared for the indices derived from detrended fluctuation analysis and frequency domain analysis of HRV. Results : In the detrended fluctuation analysis, the alpha values were 0.75${\pm}$0.11 and 0.82${\pm}$0.07 for the severe and the moderate OSAS groups respectively. The difference was significant(p<.01). The alpha value had negative correlation with AHI(r=-.425, p=.001). Negative correlation coefficients were also found in the relationships between the alpha values and very low frequency(VLF)(r=-.425, p=.001), low frequency(LF)(r=-.633, p= <.001) and the LF/HF ratio(r=-.305, p=.019) respectively. LF/HF ratio(p=.005) was higher in the severe OSAS group compared to that of the moderate OSAS group. Conclusion : In this study, the detrended fluctuation analysis showed the significant difference between the two OSAS groups classified according to their severity of symptoms. The scaling exponent showed the negative correlation with AHI and indicies of frequency domain analysis. This result suggests that detrended fluctuation analysis can be helpful to estimate the severity of OSAS.

Anxiety and Depression as Predictive Factors for Quality of Life in Patients with Advanced Gastrointestinal Cancer

Chung, JungHwa,Kwon, Jihyun,Kim, Hyun Kyung,Ju, Gawon,Kim, Seung Taik,Han, Hye Sook 대한종양간호학회 2016 Asian Oncology Nursing Vol.16 No.4

Purpose: The purpose of the present study was to assess factors associated with quality of life (QOL) and to determine whether anxiety and depression are predictive of QOL in patients with advanced gastrointestinal cancer at initial diagnosis and during the treatment process. Methods: One hundred and twenty patients with gastrointestinal cancer requiring palliative chemotherapy were enrolled. Results: At baseline, depression, performance status, and anxiety accounted for 55.0% (p<.001) of the variance in global health status score, depression accounted for 22.0% (p<.001) of the variance in functional scales score, and anxiety accounted for 19.0% (p<.001) of the variance in symptom scales score. At 3 months, depression, pain, and performance status accounted for 72.0% (p<.001) of the variance in global health status score, 76.0% (p<.001) of the variance in functional scales score, and 74.0% (p<.001) of the variance in symptom scales score. Conclusion: Anxiety and depression were significant predictive factors of QOL in patients with advanced gastrointestinal cancer. Depression and performance status were significant predictive factors of QOL at both baseline and 3 months, and anxiety and pain were significant predictive factors of QOL at baseline and 3 months, respectively.

Korean Clinical Practice Guideline for the Diagnosis and Treatment of Insomnia in Adults

Choi Hayun,Youn Soyoung,Um Yoo Hyun,Kim Tae Won,Ju Gawon,Lee Hyuk Joo,Lee Chungsuk,Lee Sang Don,Bae Kyungyeol,Kim Seong Jae,Lee Ji Hyun,Kim Tae,Chung Seockhoon 대한신경정신의학회 2020 PSYCHIATRY INVESTIGATION Vol.17 No.11

Objective We aim to present a clinical guideline for the diagnosis and treatment of insomnia in adults by reviewing and integrating existing clinical guidelines. The purpose of this guideline is to assist clinicians who perform evidence-based insomnia treatment.Methods We selected literature that may be appropriate for use in guideline development from evidence-based practice guidelines that have been issued by an academic or governmental institution within the last five years. The core question of this guideline was made in sentence form including Patient/Problem, Intervention, Comparison, Outcome (PICO) elements. After searching PubMed, EMBASE, and medical guideline issuing agencies, three guidelines were judged to be the most appropriately reviewed, up-to-date, and from trusted sources.Results The Appraisal of Guidelines for Research and Evaluation (AGREE) II tool was used to evaluate the quality of the three clinical guidelines. The final outcome of the guideline development process is a total of 15 recommendations that report the strength of the recommendation, the quality of evidence, a summary of content, and considerations in applying the recommendation.Conclusion It is vital for clinical guidelines for insomnia to be developed and continually updated in order to provide more accurate evidence-based treatments to patients.

알코올 의존 환자에서 시상 세부 영역들의 위축

이정환(Jeonghwan Lee),정승원(Seungwon Chung),박혜미(Hyemi Park),주가원(Gawon Ju),손정우(Jung-Woo Son),신철진(Chul-Jin Shin),이상익(Sang Ick Lee),김시경(Siekyeong Kim) 대한생물치료정신의학회 2020 생물치료정신의학 Vol.26 No.3

Objectives:Chronic alcohol ingestion is associated with structural alterations in the brain. In patients with alcohol dependence, thalamic volume is frequently diminished, commensurate with the amount of alcohol consumption, duration of illness, and cognitive impairment. Since the thalamus is composed of histologically and functionally distinct nuclei, we aimed to investigate volumetric changes of these nuclei in patients with alcohol dependence. Methods:Twenty-three participants with alcohol dependence who had abstained from drinking for at least 3 months (alcohol group) and 21 age-matched healthy controls (control group) underwent 3T magnetic resonance imaging. The volumes of 50 individual thalamic nuclei were reconstructed using FreeSurfer 6.0.0. We compared normalized volumes of thalamic nuclei between the two groups using analysis of covariance, controlling for age. The p-values were corrected using False Discovery Rate (p<0.05). Results:The alcohol group demonstrated atrophy of the whole thalamus and nuclei in the anterior, ventral, intralaminar, and medial thalamus. However, the volumes of bilateral lateral geniculate, medial geniculate, suprageniculatelimitans, pulvinar lateral, and right pulvinar inferior nuclei which are included in posterior thalamus, were not significantly different between the two groups. Conclusion:In the alcohol group, atrophy of most thalamic nuclei which are associated with language processing, visuospatial memory, autobiographical memory, executive function and attention were not normalized after 3 months of sobriety. Furthermore, thalamic nuclei volumes, which are associated with visual and auditory information processing, were not significantly different compared to controls. We suggest that this could be microstructural evidence of relatively preserved visual attention and auditory startle response in patients with alcohol dependence.

The Genetic Factors Affecting Drinking Behaviors of Korean Young Adults with Variant Aldehyde Dehydrogenase 2 Genotype

SieKyeong Kim,SangIck Lee,ChulJin Shin,JungWoo Son,Gawon Ju 대한신경정신의학회 2010 PSYCHIATRY INVESTIGATION Vol.7 No.4

Objective-We determined whether aldehyde dehydrogenase 2 (ALDH2) activity alters the way in which drinking behaviors are affected by gene polymorphisms of other alcohol-metabolizing enzymes and serotonin-related proteins. Methods-Through a follow-up survey with a cohort comprising 551 university freshmen over a period of 6 years, we examined the genetic factors affecting drinking behaviors. In 2000, drinking behaviors were assessed and tryptophan hydroxylase (TPH) and ALDH2 gene polymorphisms were determined. Drinking behaviors were repeated in 2006 (n=150), and the gene polymorphisms of ADH1B, ADH1C, CYP2E1, 5-HTR2A 1438A/G, and 5-HTR2A IVS2 were also determined. Results-In 2000, the variant and wild-type ALDH2 groups exhibited little difference in terms of drinking frequency and problem drinking. Furthermore, some genotypes influenced only the variant group: ADH1B*2/*2 was associated with a lower drinking frequency, and CYP2E1 c2 allele was associated with an increased risk of problem drinking. In 2006, drinking frequency and risk of problem drinking were significantly lower in the variant group than in the wild-type group. However, the TPH AA genotype disturbed that difference, meaning that the subjects in the variant group had developed a similar level of risk of problem drinking to that in the wild-type group. Conclusion-Korean university freshmen who were identified as a variant group drank as frequently as those in the wild-type group. For the subsequent 6 years they drank less frequently, thus decreasing the risk of problem drinking. However, that frequency drop was interrupted in those with gene polymorphisms such as ADH1B*1, CYP2E1 c2, and TPH A.

성 역할 정체감과 기질 성격 유형이 미용 성형 수술 의도에 미치는 영향

박혜미(Hyemi Park),이상익(Sang Ick Lee),신철진(Chul-Jin Shin),손정우(Jung-Woo Son),김시경(Siekyeong Kim),주가원(Gawon Ju) 대한생물치료정신의학회 2016 생물치료정신의학 Vol.22 No.3

Objectives:The aim of this study was to investigate the factors that determine the intention to receive cosmetic plastic surgery, with particular attention to gender role identity and temperament character. Methods:A total of 226 university students completed the self-rating scale, including cosmetic surgery intention and experience. The Korean Sex Role Inventory(KSRI), Multidimensional Body Self Relation Questionnaires(MBSRQ), Brief Body Dysmorphic Questionnaire(BBDQ), and Temperament and Character Inventory(TCI) were also measured. To evaluate the difference of body image and cosmetic surgery intention, according to sex and gender role identity, chi-square test and one-way analysis of variance were performed. To find the influential TCI dimension for cosmetic surgery intention, multiple regression analysis was performed. The mediating effect of body image in a relationship between gender role identity score, temperament character and cosmetic surgery intention was also evaluated by multiple regression analysis. Results:Body satisfaction was different according to gender role identity. The androgyny types were more satisfied with their appearance than the undifferentiated types, in both sexes. Cosmetic surgery intention was significantly different according to sex only, but not gender role identity. High masculinity and femininity scores were significantly associated with body image satisfaction, but these were not associated with intention to receive cosmetic surgery. There was a full mediating effect of body image on the relationship between cosmetic surgery intention and increased harm avoidance(HA), decreased self-directedness(SD), and decreased cooperativeness(C). Conclusion:These results show that innate difference of sex might be more important to cosmetic surgery intention than acquired gender role identity. Moreover, individuals with high HA, low SD, and low C may have difficulty in forming positive body image due to vulnerable temperament and low self-acceptance character. Negative body image, along with these characteristics would likely lead to cosmetic surgery intention.