We assessed empathy in medical residents, including factors modifying empathy and the relationship between empathy and burnout. Participants (n = 317 residents, response rate = 42%) from 4 university hospitals completed a socio-demographic questionnaire, the Jefferson Scale of Empathy (Health Professional version, Korean edition), and the Maslach Burnout Inventory (MBI). Participants were classified by medical specialty: “people-oriented specialty” (POS group) or “technology-oriented specialty” (TOS group), with more women in the POS than in the TOS group, χ2 = 14.12, P < 0.001. Being female, married, and having children were factors related to higher empathy (gender, t = -2.129, P = 0.034; marriage, t = -2.078, P = 0.038; children, t = 2.86, P = 0.005). Within specialty group, POS residents showed higher empathy scores in the fourth as compared to the first year, F = 3.166, P = 0.026. Comparing POS and TOS groups by year, fourth year POS residents had significantly higher scores than did fourth year TOS residents, t = 3.349, P = 0.002. There were negative correlations between empathy scores and 2 MBI subscales, emotional exhaustion (EE) and depersonalization (DP). Additionally, first year POS residents had higher DP scores than did first year TOS residents, t = 2.183, P = 0.031. We suggest that factors important for empathy are type of medical specialty, marriage, siblings, and children. Burnout state may be related to decreasing empathy.

The treatment of pathologic aerophagia has rarely been discussed in the literature. In this retrospective study, the authors investigated the effects of clonazepam on the management of pathologic childhood aerophagia (PCA) with psychological stresses (PS), but not with mental retardation. Data from 22 consecutive PCA patients with PS (aged 2 to 10 yr), who had been followed up for over 1 yr, were reviewed. On the basis of videolaryngoscopic views, the authors observed that the pathologyof aerophagia was the result of reflex-induced swallowing with paroxysmal openings of the upper esophageal sphincter due to unknown factors and also observed that these reflex-induced openings were subsided after intravenous low dose benzodiazepine administration. Hence, clonazepam was administered to treat paroxysmal openings in these PCA patients with PS. Remission positivity was defined as symptom-free for a consecutive 1 month within 6 months of treatment. The results of treatment in 22 PCA patients with PS were analyzed. A remission positive state was documented in 14.3% of PCA patients managed by reassurance, and in 66.7% of PCA patients treated with clonazepam (p=0.032). Thus, clonazepam may produce positive results in PCA with PS. Future studies by randomized and placebo-controlled trials are needed to confirm the favorable effect of clonazepam in PCA.

ObjectivesZZAn early diagnosis to improve the outcome of depression demands a briefer and more reliable measure than any other diagnosis. The Patient Health Questionnaire (PHQ) is reliable measure made in 1999. In this study, we tried to verify the reliabilty and validity of two types of PHQ-2, and to compare these two types. MethodsZZFrom July of 2011 to September of 2012, a total of 74 outpatients and inpatients in the Department of Psychiatry, Keimyung University Dongsan Medical Center performed the depression scales. As a normal control group, 58 individuals working in the hospital performed the PHQ-2 and PHQ-9. ResultsZZThe internal consistency and test-retest reliabilty were favorable. Two types of the PHQ-2 were statistically significant in correlation between item and total scores. In comparison of mean scores of the PHQ-2 between two groups, the differences between groups were statistically significant. Correaltion of the total scores of other depression scales with those of the PHQ-2 was statistically significant both in scales. Examined according to the severity of depression by other scales, the total mean scores of the PHQ-2 tended to increase according to the severity of depression. The optimal cutoff score was 3 in Scaled PHQ-2 (Sensitivity : 91.9%, Specificity : 100%). ConclusionZZThe assessed reliabilty and validity of the PHQ-2 made it an attractive measure for depression screening over other scales. Scaled PHQ-2 was more reliable and valid than Yes or No PHQ-2. Therefore, the PHQ-2 is a briefer and more useful measure for screening depression.

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