As the prevalence and life expectancy of type 2 diabetes mellitus (T2DM) continue to increase, the importance of effective detection and intervention for the complications of T2DM, especially neurocognitive complications including cognitive dysfunction and dementia, is receiving greater attention. T2DM is thought to influence cognitive function through an as yet unclear mechanism that involves multiple factors such as hyperglycemia, hypoglycemia, and vascular disease. Recent developments in neuroimaging methods have led to the identification of potential neural correlates of T2DM-related neurocognitive changes, which extend from structural to functional and metabolite alterations in the brain. The evidence indicates various changes in the T2DM brain, including global and regional atrophy, white matter hyperintensity, altered functional connectivity, and changes in neurometabolite levels. Continued neuroimaging research is expected to further elucidate the underpinnings of cognitive decline in T2DM and allow better diagnosis and treatment of the condition.

Background: Post-traumatic embitterment disorder (PTED) has recently been introduced as a subgroup of adjustment disorders related to stressful life events. Embitterment is defined as persistent feelings of inadequacy or hoping for revenge after being insulted but feeling helpless after experiencing a life stressor. This study aims to investigate the cumulative and differential effects of negative life events on the risk of developing embitterment among young adults in South Korea. Methods: Data for the present study were collected from a web-based survey of 1,000 young adults aged 18–35 years. All participants completed a list of negative life events, the PTED Self-Rating Scale. Logistic regression analysis was conducted to evaluate the relationships between the number of negative life events and reactive embitterment. Analyses of the relationships between each negative life event and reactive embitterment were performed using covariates, including childhood trauma, depression, and anxiety symptoms. Results: The total number of participants with reactive embitterment (cut-off scores > 2.5) was 452 (45.2%). Greater exposure to negative life events increased the risk of reactive embitterment compared to no negative events. Negative life events, including financial problems, family problems, and being excluded by friends, had significant associations with the risk of reactive embitterment. Conclusions: The present study revealed a substantial number of young adults with a high level of embitterment. Furthermore, cumulative and differential effects of negative events increased the risk for reactive embitterment. Our findings underlined the crucial role of adverse life events in the development of reactive embitterment.

Objective: Embitterment encapsulates reactive emotions such as worthlessness or helplessness after negative life events that contravene one’s basic beliefs. However, no psychological model of the development of persistent embitterment has yet been investigated. We examined mediating factors for reactive embitterment, focusing on cognitive processes, including coping and rumination, among young South Korean adults. Method: A total of 1,000 young adults aged 18–35 answered an online survey questionnaire measuring distress caused by negative life events, coping strategies, rumination, and embitterment. To examine the mediating associations of coping and rumination with embitterment, we tested path analysis models separately. Results: Distress was both directly and indirectly related to embitterment (mediated by maladaptive strategies of dysfunctional coping and intrusive rumination; total association β = .54, p < .001). The estimated indirect association of distress via maladaptive strategy with embitterment was 0.45, accounting for 82.4% of the total association of distress on embitterment. The ratio of indirect association via maladaptive strategy to direct association was 4.64. The results of this study have implications for better clinical understanding and treatment of embitterment. Conclusions: The association between dysfunctional strategies and embitterment severity suggests that clinicians should attenuate potential aggravating factors, including dysfunctional coping and intrusive rumination. Given that a combination of dysfunctional coping approaches increased the risk of reactive embitterment fourfold, these variables can be regarded as important for the development of preventive service programs for people at risk of embitterment.

Objective: In 2015, the outbreak of Middle East Respiratory Syndrome (MERS) in South Korea affected 186 patients and led to 38 bereaved families. This study aimed at investigating the nature and related factors of the psychological responses of MERS victims during the acute phase of disaster. Methods: The MERS Psychological Support Team under the Korean Ministry of Health and Welfare provided counseling services to MERS survivors and bereaved families for 4 weeks, based on crisis intervention. In this study, we reviewed the counseling records of 109 survivors and 80 bereaved family members, and analyzed their epidemiological and MERS-related information along with psychological responses. Results: Somatic symptoms and anxiety related to social stigmatization or disease transmission were common in MERS survivors, whereas grief reactions such as sadness, and anger were frequently observed in bereaved families. Bereaved MERS survivors showed more avoidance/isolation than non-bereaved MERS survivors. Females, those with an underlying physical or psychiatric health condition, and those having experienced longer duration of hospitalization and non-healthcare workers were more at risk of suffering from psychological problems. Conclusions: Survivors and bereaved families of epidemics can experience various psychological distresses depending on individual characteristics and the inherent features of the epidemic. Therefore, mental health in epidemics should be approached and considered more seriously.

Objective Alcohol use disorder (AUD) is a global burden but is also one of the most undertreated mental disorders. This study estimates the treatment rate (i.e., help-seeking status) of high-risk drinkers and factors associated with not receiving treatment in Korea using nationally representative National Health Insurance Service-National Sample Cohort (NHIS-NSC) data.Methods Among 1,025,340 participants, we eliminated those under 20 and those who did not respond to the question regarding alcohol consumption. High-risk drinkers were classified based on their frequency and quantity of alcohol consumption (4 or more drinks for women, 5 or more drinks for men per day on average). In total, 32,225 high-risk drinkers were checked for an actual AUD diagnosis to see their treatment-seeking status.Results Among 32,225 high-risk drinkers, only 1.24% had an AUD diagnosis, showing that over 98% of those who could be diagnosed with AUD are not seeking treatment. Factors associated with not seeking treatment were female sex, BMI higher or equal to 18.6, former smoker, middle-aged, and Charlson Comorbidity Index (CCI).Conclusion Our data show that many high-risk drinkers do not seek treatment in Korea. Experts, policymakers, and clinicians should promote help-seeking behavior for AUD and pay close attention to those at risk of not receiving treatment for AUD.