Contents of the Standardized Suicide Prevention Program for Gatekeeper Intervention in Korea, Version 2.0

Kyoung-Sae Na,Seon-Cheol Park,Sun-Jung Kwon,Minjae Kim,Hyoung-Jun Kim,Myungjae Baik,Jinmi Seol,Eun Ji An,Sang Min Lee,Eun-Jin Lee,Meerae Lim,Sung Joon Cho,Gwang Hun Kim,Nari Kim,Hong Jin Jeon,Jong-Woo 대한신경정신의학회 2020 PSYCHIATRY INVESTIGATION Vol.17 No.11

Objective Suicide is a huge nationwide problem that incurs a lot of socio-economic costs. Suicide also inflicts severe distress on the people left behind. The government of the Republic of Korea has been making many policy efforts to reduce suicide rate. The gatekeeper program, ‘Suicide CARE’, is one of the meaningful modalities for preventing suicide. Methods Multidisciplinary research team collaborated to update the ‘Suicide CARE’ to version 2.0. Results In the ‘Introductory part’, the authors have the time to think about the necessity and significance of the program before conducting full-scale gatekeeper training. In the ‘Careful observation’ part, trainees learn how to understand and recognize the various linguistic, behavioral, and situational signals that a person shows before committing suicide. In the ‘Active listening’ part, trainees learn how to ask suicide with a value-neutral attitude as well listening empathetically. In the ‘Risk evaluation and Expert referral’ part, trainees learn intervening strategies to identify a person’s suicidal intention, plan, and past suicide attempts, and connect the person to appropriate institutes or services. Conclusion Subsequent studies should be conducted to verify the efficacy of the gatekeeper program.

Differential effect of COMT gene methylation on the prefrontal connectivity in subjects with depression versus healthy subjects

Na, Kyoung-Sae,Won, Eunsoo,Kang, June,Kim, Aram,Choi, Sunyoung,Tae, Woo-Suk,Kim, Yong-Ku,Lee, Min-Soo,Joe, Sook-Haeng,Ham, Byung-Joo Elsevier 2018 NEUROPHARMACOLOGY - Vol.137 No.-

<P><B>Abstract</B></P> <P>Expression of the catechol-O-methyl transferase (COMT) gene mainly determines prefrontal dopaminergic availability. Deficient prefrontal dopaminergic activity leads to loss of interest, energy, and motivation, which are core symptoms of depression. Given the role of stress-environmental interactions in major depressive disorder (MDD), we investigated the impact of COMT gene methylation status on prefrontal connectivity. We measured COMT gene methylation and polymorphisms (Val158Met) at the <I>rs4468</I> locus in peripheral blood samples of healthy controls (n = 90) and patients with MDD (n = 90). We used diffusion tensor imaging to calculate the fractional anisotropy (FA) and radial diffusivity (RD) of the white matter tracts related to prefrontal cortex. Finally, we examined the effects of COMT gene methylation on the white matter connectivity in patients with MDD. The FA and RD values in the prefrontal white matter tracts of patients with MDD were positively and negatively associated with COMT gene methylation, respectively. In the control group, on the other hand, the association between white matter connectivity and COMT gene methylation showed opposite pattern to those of MDD. COMT gene methylation has a substantial effect on the prefrontal connectivity in patients with MDD. Moreover, COMT gene methylation and prefrontal connectivity showed opposite relationships in patients and controls. Thus, stress-related alterations in dopaminergic neurotransmission have a differential effect on white matter connectivity according to the microenvironment in the brain.</P> <P><B>Highlights</B></P> <P> <UL> <LI> COMT gene methylation was lower in patients with depression than in healthy control individuals. </LI> <LI> The FA (and RD) of the white matter tracts of the PFC were lower (and higher) in patients than those in controls. </LI> <LI> The COMT gene methylation had opposite relationships with white matter connectivity in the two groups. </LI> </UL> </P>

A Survey on the Perception for the Disaster Mental Health Services among General Population

Kyoung-Sae Na,Myung-Soo Lee,Jinhee Hyun,Ilsung Nam 대한신경정신의학회 2016 신경정신의학 Vol.55 No.3

Objectives Disasters exert substantial effects on the mental health of victims and bereaved populations. Thus, a systematic framework for preparing and providing psychosocial and mental health services is necessary. The current attitudes toward and knowledge of disaster mental health-related factors among the general population provides one component for development of the disaster mental health services framework. Methods The authors analyzed a web-based survey for disaster mental health-related factors among the general population. Responses for the knowledge and perception for the disaster mental health services were compared between people who experienced and did not experience disaster. Results One thousand and three people completed the questionnaire. One hundred and seventy (16.9%) people experienced more than one disaster. People who experienced a disaster were more disturbed by disaster broadcasting or reporting than people who had not. People who experienced a disaster gave disaster mental health services an average score 63.5. People who experienced a disaster perceived group psychotherapy and self-help meetings as less important than those who had not. The recognition of both community mental health center and disaster mental health center was higher in the experienced group than non-experienced. Conclusion This study revealed that general satisfaction with the current disaster mental health service is low, particularly among people who have used disaster mental health services. A national mental health system for disaster victims should be established with consideration for efficiency, effectiveness and accessibility.

노년기 양극성 장애

나경세(Kyoung-Sae Na),백종우(Jong-Woo Paik) 대한노인정신의학회 2009 노인정신의학 Vol.13 No.1

Growing body of evidence has suggested that bipolar disorder in the elderly is important issue of mental health care. While older bipolar patients show different clinical features and response to treatment compared to younger patients, there are few studies focused on the older bipolar patients. Authors reviewed clinical features and treatment issues for bipolar disorder in the elderly.

정상인에서 메칠페니데이트가 학습에 미치는 영향

나경세(Kyoung-Sae Na),이소영(Soyoung Irene Lee) 대한소아청소년정신의학회 2012 소아청소년정신의학 Vol.23 No.2

Methylphenidate is a widely used stimulant for treatment of attention-deficit hyperactivity disorder (ADHD). In addition to core symptoms of attention and behavioral symptoms, methylphenidate is even effective for executive functions. However, abuse and misuse of stimulants, including methylphenidate, for the purpose of cognitive enhancement is an issue of concern worldwide. Some prejudices and misunderstandings against methylphenidate are popular ; however, little attention has been given to the neuropsychiatric evidence of methylphenidate for enhancement of cognitive function among healthy populations. In this article, our aim was to conduct a review of previous studies investigating the effect of methylphenidate in healthy populations. Findings from several recent studies have demonstrated the effectiveness of methylphenidate for enhancement of cognitive function in healthy populations. The mechanisms of cognitive enhancement are thought to be associated with motivation and the reward circuit in the brain. However, when considering the risk to benefit, an official discussion of the use of methylphenidate among healthy members of the population would be premature. Instead, investigation of epidemiological studies of the prevalence of misuse of stimulants among healthy members of the population, particularly adolescents and college students, is needed. In addition, based on achievements reported in previous studies, investigation of the effect of an approach using non-pharmacological enhancing motivation, which will in turn result in increased cognitive function would be helpful.

¹⁸F-FDG PET/CT Can Predict Survival of Advanced Hepatocellular Carcinoma Patients: A Multicenter Retrospective Cohort Study

Na, Sae Jung,Oh, Jin Kyoung,Hyun, Seung Hyup,Lee, Jeong Won,Hong, Il Ki,Song, Bong-Il,Kim, Tae-Sung,Eo, Jae Seon,Lee, Sung Won,Yoo, Ie Ryung,Chung, Yong An,Yun, Mijin Society of Nuclear Medicine 2017 The Journal of nuclear medicine Vol.58 No.5

<P>Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) consists of a heterogeneous group of patients with a wide range of survival times, requiring further prognostic stratification to facilitate treatment allocation. We evaluated the prognostic value of F-18-FDG uptake on PET/CT at the time of presentation in patients with BCLC stage C HCC. Methods: A total of 291 patients with BCLC stage C HCC who underwent F-18-FDG PET/ CT between 2009 and 2010 for staging were retrospectively enrolled from 7 university hospitals. The patients were further divided into 2 groups according to the extent of disease, as intrahepatic or extrahepatic. Tumor-to-liver SUV ratio (TLR) of the primary tumor was measured on F-18-FDG PET/CT. Prognostic values of TLR and other clinical variables were analyzed to predict overall survival (OS) in univariate and multivariate analyses. Differences in the OS stratified by TLR were examined by the Kaplan Meier method. Results: Higher TLR was associated with extrahepatic disease (P = 0.018). On multivariate analysis, Child Pugh classification and TLR were independent prognostic factors in the intrahepatic disease group (all P < 0.05), whereas TLR was the only independent prognostic factor in the extrahepatic disease group (P < 0.05). Patients with high TLR showed a significantly worse OS than those with low TLR (P < 0.05) in both groups. Conclusion: In patients with BCLC stage C HCC, F-18-FDG uptake in the primary tumor was significantly higher in patients with extrahepatic disease than in those with intrahepatic disease. In addition, F-18-FDG uptake on pretreatment PET/CT had an incremental prognostic value for OS in both intrahepatic and extrahepatic disease groups.</P>

친환경적 다기능 패션디자인의 조형적 특성

이경희 ( Kyoung Hee Lee ),김새봄 ( Sae Bom Kim ),나은미 ( Eun Mi Na ) 복식문화학회 2011 服飾文化硏究 Vol.19 No.1

This purpose of this study was to analyze the formation and look into design characteristics by types and method of expression on multifunctional eco-friendly fashion design. Total 191 pieces of multifunctional fashion design photographs were collected through fashion collection from 2000 S/S to S/S 2010 F/W on the website. First, the characteristics of multifunctional eco-friendly fashion design used squared silhouette, achromatic colors, plain patterns for pollution control, hard materials to prolong the product, it was clear that details were minimized to save resources. Second, there were 5 changeable types of multifunctional eco-friendly fashion design which were changes in changing forms, material changes, item changes, detail changes and complex changes. Third, as the result of changeable types by method of expression, the changing forms were expressed by removable, materiel changes by reversible, detail changes by open and close and item changes by shifting. Forth, the formative properties of multifunctional eco-friendly fashion design had flexibility, multifunction, versatility and amusing. Therefore, this study will be helpful in planning multifunctional eco-friendly fashion design according to the kind of formative characteristics, changeable types, method of expression and provide concrete fundamental materials for the expert in clothing on the base of objective data through statistical analysis.

DRD2 Genotypic and Haplotype Variation Is Associated With Improvements in Negative Symptoms After 6 Weeks’ Amisulpride Treatment

Kang, Seung-Gul,Na, Kyoung-Sae,Lee, Heon-Jeong,Chee, Ik-Seung,Lee, Kwanghun,Lee, Jonghun Wolters Kluwer Health, Inc. All rights reserved. 2015 JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY Vol.35 No.2

ABSTRACT: The aim of this study was to identify the association between the rs1079597 and rs1800497 genetic polymorphisms of the gene encoding the dopamine D2 receptor (DRD2) protein and the treatment response to the selective dopamine receptor antagonist amisulpride. After 6 weeks of treatment with amisulpride, 125 schizophrenia patients were interviewed based on the Positive and Negative Syndrome Scale and the Clinical Global Impression-Severity Scale. Genotyping for rs1079597 and rs1800497 was performed using the TaqMan single nucleotide polymorphism genotyping assay. There were significant differences in the genotype frequency of the recessive model (&khgr; = 5.73, P = 0.017) and allele frequency (&khgr; = 5.16, P = 0.023) of rs1079597 between the responders and nonresponders based on the Positive and Negative Syndrome Scale negative symptoms scores. There was no significant finding in this regard for the rs1800497 polymorphism. The T-C and C-C haplotype of rs1079597-rs1800497 were associated with the negative symptom treatment response to amisulpride after permutation test. To the best of our knowledge, this is the first report of the positive finding in the association study between rs1079597 polymorphism and the treatment response to amisulpride in schizophrenic patients. A larger scale study involving more single nucleotide polymorphisms of DRD2 will progress the research into the pharmacogenetics of the treatment response to amisulpride.

Clinical Usefulness of Amisulpride Add-on Therapy in Schizophrenia Patients without Treatment Response to Second-generation Antipsychotics

Seung-Gul Kang,조서은,Kyoung-Sae Na,Chi Un Pae,조성진 대한정신약물학회 2021 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.19 No.1

Objective: The response to antipsychotics in patients with schizophrenia is still unsatisfactory. Therefore, augmentation with other antipsychotics is common in clinical situations. The purpose of this study was to evaluate the improvement of psychiatric symptoms and side effects after amisulpride add-on therapy. Methods: Forty patients with schizophrenia or schizoaffective disorder without treatment response to second-generation antipsychotics were included in this study. Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS) and the Korean version of Calgary Depression Scale for Schizophrenia (CDSS) at baseline, 4 weeks, and 8 weeks after the addition of amisulpride. Results: Among the 29 subjects who completed the 8-week study, 34.5% were responders according to PANSS total score. At week 8, the mean positive (p < 0.001), negative (p < 0.001), general (p < 0.001), and total (p < 0.001) PANSS scores and CDSS scores (p = 0.002) showed significant improvement compared to baseline. There was no increase in extrapyramidal side effects according to Simpson Angus Scale (p = 0.379) and Barnes Akathisia Rating Scale (p = 0.070) and no weight gain (p = 0.308) after the add-on treatment. Conclusion: The addition of amisulpride for schizophrenia patients without therapeutic response to second-generation antipsychotics is considered an effective and safe treatment. This study's results suggested that augmentation of second- generation antipsychotics with amisulpride could be a useful option for patients with schizophrenia unresponsive to second-generation antipsychotics. Further studies investigating the efficacy of amisulpride add-on therapy using placebo control are necessary to confirm these results.

“Suicide CARE” (Standardized Suicide Prevention Program for Gatekeeper Intervention in Korea): An Update

Seon-Cheol Park,Kyoung-Sae Na,Sun-Jung Kwon,Minjae Kim,Hyoung-Jun Kim,Myungjae Baik,Jinmi Seol,Eun Ji An,Sang Min Lee,Eun-Jin Lee,Meerae Lim,Sung Joon Cho,Gwang Hun Kim,Nari Kim,Hong Jin Jeon,Jong-Woo 대한신경정신의학회 2020 PSYCHIATRY INVESTIGATION Vol.17 No.9

Objective In 2011, “Suicide CARE” (Standardized Suicide Prevention Program for Gatekeeper Intervention in Korea) was originally developed for the early detection of warning signs of suicide completion, since there is a tendency to regard emotional suppression as a virtue of Korean traditional culture. A total of 1.2 million individuals completed the training program of “Suicide CARE” in Korea. Methods More sophisticated suicide prevention approaches according to age, sex, and occupation have been proposed, demanding for a more detailed revision of “Suicide CARE.” Thus, during the period from August 2019 to February 2020, “Suicide CARE” has been updated to version 2.0. The assessments on domestic gatekeeper training programs for suicide prevention, international gatekeeper training programs for suicide prevention, psychological autopsy interview reports between 2015 and 2018, and the evaluation of feedback from people who completed “Suicide CARE” version 1.6 training were performed. Results We describe the revision process of “Suicide CARE,” revealing that “Suicide CARE” version 2.0 has been developed using an evidence-based methodology. Conclusion It is expected that “Suicide CARE” version 2.0 be positioned as the basic framework for many developing gatekeeper training programs for suicide prevention in Korea in the near future.