The objective was to estimate the prevalence and correlates of psychiatric disorders in a nationwide sample of Korean adults. Face-to-face interviews were conducted with the Korean version of Composite International Diagnostic Interview 2.1/DSM-IV (N = 6275, response rate 79.8%). The lifetime and 12-month prevalences for all types of DSM-IV disorders were 33.5% and 20.6%, respectively. Those of specific disorders were as follows: 17.2% and 7.1% for alcohol use disorder, 11.2% and 7.4% for nicotine use disorder, 5.2% and 4.2% for specific phobia, 4.3% and 1.7% for major depressive disorder, and 2.3% and 1.0% for generalized anxiety disorder. Among the sociodemographic variables, widowed status, higher income, and rural residence were the risk factors for both lifetime major depressive disorder and alcohol use disorder after controlling for gender, age, and education. The prevalence of psychiatric disorders was higher than those observed in other East-Asian countries and most European countries, but lower than that in the United States. Alcohol use disorder was particularly high in Korea.

ObjectiveThe aim of this study was to estimate the prevalence and correlates of mental disorders in Korean adults.MethodsDoor to door household surveys were conducted with community residents aged 18-74 years from July 19, 2011, to November 16, 2011 (n=6,022, response rate 78.7%). The sample was drawn from 12 catchment areas using a multistage cluster method. Each subject was assessed using the Korean version of the World Health Organization Composite International Diagnostic Interview (CIDI) based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).ResultsLifetime and 12-month prevalence estimates were as follows: alcohol use disorders, 13.4% and 4.4%, respectively; nicotine use disorders, 7.2% and 4.0%, respectively; anxiety disorders, 8.7% and 6.8%, respectively; and mood disorders, 7.5% and 3.6%, respectively. The prevalence rates of all types of DSM-IV mental disorders were 27.6% and 16.0%, respectively. Being female; young; divorced, separated, or widowed; and in a low-income group were associated with mood and anxiety disorders after adjustment for various demographic variables, whereas being male and young were associated with alcohol use disorders. Higher income was not correlated with alcohol use disorder as it had been in the 2001 survey.ConclusionThe rate of depressive disorders has increased since 2001 (the first national survey), whereas that of anxiety disorders has been relatively stable. The prevalence of nicotine and alcohol use disorders has decreased, and the male-to-female ratio of those with this diagnosis has also decreased.

Summary The aim of this study is to examine relationships of sleep duration with sociodemographic and health‐related factors, psychiatric disorders and sleep disturbances in a nationwide sample in Korea. A total of 6510 subjects aged 18–64 years participated in this study. Logistic regression was used to calculate the odd ratios and 95% confidence intervals of the covariates, psychiatric disorders and sleep disturbances across the following sleep duration categories: 5 h or less, 6, 7, 8 and 9 h or more per day. Low levels of education, unemployment and physical illness were associated with sleeping for 5 h or less and 9 h or more. Being older and widowed/divorced/separated, high levels of physical activity, pain/discomfort, obesity and high scores on the General Health Questionnaires were associated with sleeping for 5 h or less. Female, being younger and underweight were associated with sleeping for 9 h or more. Alcohol dependence, anxiety disorder and social phobia were associated significantly with sleeping for 5 h or less and 9 h or more. Other psychiatric disorders were more common in subjects who slept for 5 h or less (e.g. alcohol use disorder, mood disorder, major depressive disorder, dysthymic disorder, obsessive‐compulsive disorder and specific phobia) or 9 h or more (e.g. post‐traumatic stress disorder). In addition, subjects who slept for 5 h or less reported more sleep disturbances than did subjects who slept for 7 h. Short or long sleep is associated with psychiatric disorders and/or sleep disturbance, therefore attention to the mental health of short or long sleepers is needed.

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ObjectiveThis retrospective case series study of the effectiveness of electroconvulsive therapy (ECT) augmentation on clozapine-resistant schizophrenia was conducted by EMR review.MethodsClozapine-resistance was defined as persistent psychotic symptoms despite at least 12 weeks of clozapine administration with blood levels over 350 ng/mL in order to rule out pseudo-resistance. Seven in-patients who were taking clozapine and treated with ECT were selected. We analyzed the psychopathology and subscales changed by ECT.ResultsThe average number of ECT sessions was 13.4 (±4.6). Total Positive and Negative Syndrome Scale (PANSS) score was significantly reduced by 17.9 (±12.8) points (p=0.0384) on average, which represented a reduction of 25.5% (±14.3). 71.4% (5/7) of patients were identified as clinical remission, with at least a 20% reduction in PANSS score. PANSS reduction was associated with number of ECT sessions, stimulus level in the final session, and blood clozapine levels before ECT. However, the negative subscale on the PANSS were not reduced by ECT in any patient. We did not observe any persistent adverse cognitive effects.ConclusionThis study supports that ECT augmentation on clozapine-resistant schizophrenia reveals clinically effective and safe. Further research should be done involving a larger number of patients to investigate the effectiveness of clozapine/ECT combination therapy.

ObjectiveThis study aimed to investigate the effectiveness and tolerability of the combination of electroconvulsive therapy (ECT) in patients with clozapine-treated schizophrenia. MethodsPatients with clozapine-treated schizophrenia during five years of pre-determined period were recruited from Electronic Medical Record. Clinical effects of acute ECT on psychotic symptoms were investigated. We also tried to identify predictive variables requiring maintenance treatment of ECT. ResultsFourteen patients received ECT and clozapine and sixteen were treated with clozapine alone. In the ECT group, which could be refined as clozapine-resistance, PANSS total score was significantly reduced by 19.0±9.9 points, corresponding to a reduction rate of 18.5±8.3%. The clinical remission defined as 20% PANSS reduction criteria was achieved at 42.9%. The subscale factors were significantly reduced, among which the negative symptom was the least. There was no difference in demographic and clinical information between patients receiving and not receiving maintenance ECT, and not all patients seemed to need maintenance ECT if clozapine is continued. ConclusionCombination of ECT and clozapine in patients with clozapine-resistant schizophrenia resulted in a rapid and substantial reduction of psychotic symptoms. Further studies are needed to improve the effectiveness and tolerability of ECT.

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ObjectiveAttention-deficit/hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder with a strong genetic component. Brain-derived neurotrophic factor (BDNF), which participates in the differentiation and survival of dopaminergic and noradrenergic neurons, could play a role in ADHD development. We aimed to explore the relationships between ADHD and BDNF gene polymorphism.MethodsWe conducted a case-control analysis of 202 ADHD subjects and 159 controls, performed a transmission disequilibrium test on 151 trios, and compared the results of a continuous performance test (CPT) according to the genotype of the three single nucleotide polymorphisms (rs11030101, rs6265, rs16917204) in the BDNF gene.ResultsIn the case-control analysis, the AA genotype of the BDNF rs11030101 polymorphism was significantly associated with ADHD only in girls (p=0.024, odds ratio=3.00). The T-G-G haplotype was significantly less frequent (p=0.005) and A-G-G was more frequent (p=0.048) in girls with ADHD than in control girls (global p=0.027). A multivariate analysis of variance for commission errors on the CPT showed a significant main effect for the rs11030101 genotype (p=0.026) and an interaction effect of the rs11030101 genotype and gender (p=0.032) in ADHD probands.ConclusionThese results provide preliminary evidence for a gender-specific association between BDNF and ADHD in the Korean population.