Comorbid psychiatric disorders in adults with ADHD are important because these comorbidities might complicate the diagnosis of ADHD and also worsen the prognosis. However, the prevalence of comorbid psychiatric disorders in adult ADHD varies according to the diagnostic tools used and the characteristics of target populations. The purpose of this review was to describe the prevalence of comorbid psychiatric disorders in adults with ADHD compared with adults without ADHD. Thirty-two studies published before August 2022 were identified and classified according to diagnosis of other psychiatric disorder in those with ADHD. The most frequent comorbid psychiatric disorder in the ADHD group was substance use disorder (SUD), followed by mood disorders, anxiety disorders, and personality disorders. The prevalence of these four disorders was higher in the ADHD group, whether or not subjects were diagnosed with other psychiatric disorders. In addition, the diversity of ADHD diagnostic tools was observed. This also might have affected the variability in prevalence of comorbidities. Standardization of ADHD diagnostic tools is necessary in the future.

Background Previous studies have investigated the association between suicide and internet search volumes of terms related to suicide or self-harm. However, the results varied by people’s age, period, and country, and no study has exclusively investigated suicide or self-harm rates among adolescents. Objective This study aims to determine the association between the internet search volumes of terms related to suicide/self-harm and the number of suicides among South Korean adolescents. We investigated gender differences in this association and the time lag between the internet search volumes of the terms and the connected suicide deaths. Methods We selected 26 search terms related to suicide and self-harm among South Korean adolescents, and the search volumes of these terms for adolescents aged 13-18 years were obtained from the leading internet search engine in South Korea (Naver Datalab). A data set was constructed by combining data from Naver Datalab and the number of suicide deaths of adolescents on a daily basis from January 1, 2016, to December 31, 2020. Spearman rank correlation and multivariate Poisson regression analyses were performed to identify the association between the search volumes of the terms and the suicide deaths during that period. The time lag between suicide death and the increasing trend in the search volumes of the related terms was estimated from the cross-correlation coefficients. Results Significant correlations were observed within the search volumes of the 26 terms related to suicide/self-harm. The internet search volumes of several terms were associated with the number of suicide deaths among South Korean adolescents, and this association differed by gender. The search volume for “dropout” showed a statistically significant correlation with the number of suicides in all adolescent population groups. The correlation between the internet search volume for “dropout” and the connected suicide deaths was the strongest for a time lag of 0 days. In females, self-harm and academic score showed significant associations with suicide deaths, but academic score showed a negative correlation, and the time lags with the strongest correlations were 0 and –11 days, respectively. In the total population, self-harm and suicide method were associated with the number of suicides, and the time lags with the strongest correlations were +7 and 0 days, respectively. Conclusions This study identifies a correlation between suicides and internet search volumes related to suicide/self-harm among South Korean adolescents, but the relatively weak correlation (incidence rate ratio 0.990-1.068) should be interpreted with caution.

IntroductionMany adolescents with suicidal ideation receive support through the Internet. However, they also find ways to attempt suicide or strengthen their suicidal ideation through this medium. This study analyzed the association between the search volume of suicide-related terms and the number of suicides among Korean adolescents. We also analyzed the correlations between the search volumes of suicide-related terms.MethodsWe selected seven words (suicide, self-injury, depression, academic score, school violence, outcasts, and family trouble) related to adolescent suicide. A dataset was constructed by combining data from the most commonly used search engine in Korea (Naver Datalab) and the daily number of adolescent suicides in school settings (n = 347) from January 1, 2016 to December 31, 2018, collected from the Ministry of Education. Poisson regression and Pearson correlation analyses were performed.ResultsSignificant associations were found between suicide attempts and search term volumes, which differed according to sex and time interval. Among the search terms, “self-injury” was most strongly associated with suicide, and this association was significant at all time intervals (daily, weekly, and monthly) in female adolescents and in the total population. Further, the association was strongest in the daily suicide data. More search term volumes were related to suicide in the daily and weekly data than in the monthly data. There were positive correlations between “suicide,” “self-injury,” and “depression” search volumes.ConclusionFurther studies with larger sample sizes, more search terms, and analysis of time intervals between suicide-related term search and suicide death are required. These studies can contribute to the establishment of an online suicide prevention system to detect suicide risk in adolescents and provide interventions.

Objective: The purpose of this study was to compare the efficacy and tolerability of continued olanzapine (OLA) versus amisulpride (AMI) augmentation in schizophrenic patients with poor response to OLA monotherapy. Methods: The present 4-week, randomized, rater-blinded study included 25 patients with schizophrenia who were partially or completely unresponsive to treatment with OLA monotherapy. Eligible subjects were randomly assigned at a 1:1 ratio to continuation of OLA monotherapy (OLA group) or OLA with AMI augmentation (AMI group). Efficacy was primarily evaluated using the Positive and Negative Syndrome Scale (PANSS) at baseline and at 1, 2, and 4 weeks. Results: The changes in PANSS total score and PANSS-positive subscale score were significantly different (p ＜ 0.05) between the OLA and AMI groups. The differences between the two groups in PANSS-negative subscale, PANSS-general subscale, Brief Psychiatric Rating Scale, and Clinical Global Impression-Severity (CGI-S) scale scores were not statistically significant. Conclusion: AMI augmentation could be an effective strategy for patients with schizophrenia who show inadequate early response to OLA monotherapy.

BACKGROUND Previous studies have investigated the association between suicide and the Internet search volumes of terms related to suicide or self-harm. However, their results have varied by age, period, and country, and no studies have exclusively investigated adolescents. OBJECTIVE This study aimed to determine the association between the Internet search volumes of terms related to suicide/self-harm and the number of suicides among Korean adolescents. Gender differences in this association and the time lag between the Internet search volumes of the terms and connected suicide deaths are investigated. METHODS We selected 26 search terms related to suicide and self-harm of Korean adolescents, and the search volumes of these terms for adolescents aged 13–18 years were obtained from the leading Internet search engine in Korea (Naver Datalab). A data set was constructed by combining data from Naver Datalab and the number of the suicide deaths of adolescents on a daily basis from January 1, 2016 to December 31, 2020. Spearman’s rank correlation and multivariate Poisson regression analyses were used to identify the association between the search volumes of the terms and the suicide deaths during that period. The time lag between suicide death and in the increasing trend of the search volumes of related terms was estimated from the cross-correlation coefficients. RESULTS Significant correlations within the search volumes of 26 terms related to suicide/self-harm were observed. The Internet search volumes of several terms were associated with the number of suicide deaths in Korean adolescents, and this association differed by gender. The search volume for “dropout” showed a statistically significant correlation with the number of suicides in all adolescent population groups. The correlation between the Internet search volume for “dropout” and connected suicide deaths was strongest for a time lag of 0 days. In females, “self-harm” and “academic score” showed significant associations with suicide deaths, but “academic score” showed a negative correlation, and the time lags with the strongest correlations were 0 and -11 days, respectively. In the total population, “self-harm” and “suicide method” were associated with the number of suicides, and the time lags with the strongest correlations were +7 and 0 days, respectively. CONCLUSIONS The time lag with the strongest correlation between the internet search volume and suicide death was shorter than expected. Therefore, a real-time surveillance system for monitoring changing trends of terms related to suicide/self-harm is suggested with the monitored search terms being gender specific.

No abstract

No abstract

ObjectivesZZThe traditional roles of psychiatrists are being threatened according to the changes of requests from society. Psychiatrists need to rapidly adapt to new upcoming circumstances, improve leadership skills, and prepare for emerging ethical problems. The aim of this study is to predict and suggest what will happen in the future in the area of mental health, what role models might be required, what we should do and how we can prepare.MethodsZZThe authors interviewed seven mental health professionals on topics of leadership, participating roles of psychiatrists. Three models for psychiatrists were suggested : clinical model, community leader model, and mental health promoting model. Afterwards, a questionnaire on each role model was distributed to members of the Korean Neuropsychiatric Association via email and results were analyzed.ResultsZZExperts and stakeholders suggested that the following components from the interview will be fostered in the future : leadership in collaboration with other communities, introduction of leadership programs for young psychiatrists, strategies for sensitization of ethical issues, active communication with community partners, training professionals in legislation and administration. Regarding the questionnaire, 32 members responded. The most preferred role model was the Community leader model (46.9%, n=15), followed by the mental health promoting model (34.4%, n=11) and clinical model (15.6%, n=5). Most responders recognized that these issues are emerging and answered affirmatively on the developmental potential of each role model. A question about primary agents who are supposed to take charge of development of a suitable model was answered as follows : university professors for the clinical model (37.5%, n=12), psychiatrists working for public hospitals both for community leader (28.1%, n=9), and mental health promoting model (43.8%, n=14). Various opinions on leadership and strategies for fulfilling the role model were proposed.ConclusionZZThis study investigated leadership, ethics, social roles, and future directions of psychiatrists in order to provide suggestions on how to properly respond to changes of environment. It is expected that this study will be helpful in establishment of guidelines for leadership development and improving ethical orientation of psychiatrists, and will provide an opportunity for Korean NeuroPsychiatric Association members to have deep consideration and radical debate on our transforming roles.J Korean Neuropsychiatr Assoc 2014;53(2):92-98 KEY WORDSZZ Leadership · Ethics, medical · Professional role · Mental health.