1
|
Jeon SE, Ryu S, Lee JY, Kim JM, Kim SW, Kang YS. The Effect of Fear of COVID-19 Infection and Anxiety on Loneliness: Moderated Mediation Effects of Gratitude. Psychiatry Investig 2023; 20:870-879. [PMID: 37794669 PMCID: PMC10555511 DOI: 10.30773/pi.2023.0170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/05/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE This study was conducted to identify factors related to loneliness during the coronavirus disease-2019 (COVID-19) pandemic and focused on how the fear of COVID-19 infection affects loneliness and the conditional effect of gratitude as a moderator in the relationship among the fear of COVID-19, anxiety, and loneliness. METHODS For the analysis of this study, a survey was conducted among 1,500 individuals aged 19 to 69 years living in three metropolitan areas in South Korea. Questionnaires included sociodemographic data, psychological experience and stress associated with COVID-19, Generalized Anxiety Disorder Scale-7, UCLA Loneliness Scale-3, and Gratitude Questionnaire-6. An analysis was conducted by applying SPSS PROCESS macro models 4 and 7. RESULTS First, anxiety mediated the relationship between the fear of COVID-19 infection and loneliness. Second, the effect of the fear of COVID-19 infection on loneliness through anxiety was moderated by gratitude. The higher the gratitude, the more the fear of COVID-19 infection is buffered in the path to anxiety, and the lower the indirect effect on loneliness. CONCLUSION This suggests that in the context of the COVID-19 pandemic, interventions for psychological problems such as anxiety and loneliness can be carried out through gratitude, a significant protective variable.
Collapse
Affiliation(s)
- Seong-Eun Jeon
- Department of Psychology, Chonnam National University, Gwangju, Republic of Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Republic of Korea
| | - Young-Shin Kang
- Department of Psychology, Chonnam National University, Gwangju, Republic of Korea
| |
Collapse
|
2
|
Ryu S, Kim JW, Lee JY, Kang YS, Shin HY, Jung SI, Kim JM, Kim SW. Psychological and Personality Characteristics Associated With COVID-19 Vaccination Behavior in Korean General Population. J Korean Med Sci 2023; 38:e234. [PMID: 37527911 PMCID: PMC10396430 DOI: 10.3346/jkms.2023.38.e234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/30/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND This study characterized coronavirus disease 2019 (COVID-19) vaccination behavior in the Korean general population using cluster analysis and explored related psychological factors. METHODS We categorized 1,500 individuals based on their attitudes toward COVID-19 vaccination using hierarchical clustering and identified their level of vaccine acceptance. We examined the associations between vaccine acceptance and behavioral and psychological characteristics. RESULTS Clustering revealed three groups according to vaccine acceptance: 'totally accepting' (n = 354, 23.6%), 'somewhat accepting' (n = 523, 34.9%), and 'reluctant' (n = 623, 41.5%). Approximately 60% of all participants who belonged to the 'totally accepting' and 'somewhat accepting' groups were willing to receive a COVID-19 vaccine despite concerns about its side effects. High vaccine acceptance was associated with older age, regular influenza vaccination, and trust in formal sources of information. Participants with high vaccine acceptance had higher levels of gratitude, extraversion, agreeableness, and conscientiousness, and lower levels of depression, anxiety, and neuroticism. CONCLUSIONS People weighed the benefits of COVID-19 vaccination against the risk of side effects when deciding to receive the COVID-19 vaccine. Our findings also indicate that this vaccination behavior may be affected by coping mechanisms and psychological factors.
Collapse
Affiliation(s)
- Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Young-Shin Kang
- Department of Psychology, Chonnam National University, Gwangju, Korea
| | - Hee-Young Shin
- Department of Biomedical Science, Chonnam National University Medical School, Gwangju, Korea
| | - Sook-In Jung
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Korea.
| |
Collapse
|
3
|
Li L, Yang H, Zhang R, Wang Y, Bian G. Effect of COVID-19 pandemic on serious mental illness-related outpatient department utilization in Ningbo, China: an interrupted time series analysis. Front Psychiatry 2023; 14:1199408. [PMID: 37520234 PMCID: PMC10372427 DOI: 10.3389/fpsyt.2023.1199408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Background Globally, the coronavirus disease 2019 (COVID-19) pandemic has negatively affected mental health services, but there is no clear evidence of this in China. Therefore, we examined the effect of the COVID-19 pandemic on the use of serious mental illness (SMI)-related outpatient services in Ningbo, China. Methods We analyzed the trends in monthly SMI-related outpatient department utilization from January 2018 to June 2022 using interrupted time series (ITS) regression analysis, and we defined the onset of the COVID-19 pandemic as January 2020. We also performed ITS regression analyses for sex and age subgroups. Results A significant difference in the monthly number of outpatient visit slopes before and after the onset of the pandemic was shown in the SMI analysis [-175.6, 95% confidence interval (CI) (-338.3 to -12.9), p < 0.05]. All sex and age categories, except the 20-30 years age category, showed statistically significant changes in their slopes after the onset of the pandemic. Significant differences in the number of outpatient visit slopes before and after the onset of the pandemic were seen for schizophrenia and bipolar disorders [-153.3, 95% CI (-294.1 to -12.5) and -16.8 (-31.0 to -2.6), respectively]. Moreover, a negative relationship was observed between the monthly number of outpatient visits and the number of incidents and accidents due to SMI (r = -0.38, p < 0.05). Conclusion The COVID-19 pandemic has had a negative effect on SMI-related outpatient visits in Ningbo, especially by patients with schizophrenia. A strategy should be developed and implemented to maintain access to SMI services during the COVID-19 pandemic.
Collapse
|
4
|
Ryu S, Nam HJ, Jhon M, Lee JY, Kim JM, Kim SW. Trends in suicide deaths before and after the COVID-19 outbreak in Korea. PLoS One 2022; 17:e0273637. [PMID: 36094911 PMCID: PMC9467344 DOI: 10.1371/journal.pone.0273637] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 08/10/2022] [Indexed: 12/03/2022] Open
Abstract
We investigated the effect of the coronavirus disease-2019 (COVID-19) pandemic on suicide trends in Korea via a time-series analysis. We used Facebook Prophet to generate forecasting models based on the monthly numbers of suicide deaths in Korea between 1997 and 2018, validated the models by comparison with the 2019 numbers, and predicted the numbers of suicides in 2020. We compared the expected and observed numbers of suicides during the COVID-19 pandemic. The total numbers of suicides during the COVID-19 pandemic did not deviate from projections based on the pre-pandemic period. However, the number of suicides among women and those under the age of 34 years significantly exceeded the expected level. The COVID-19 pandemic did not increase the overall suicide rate significantly. However, suicides among women and young people increased, suggesting that the pandemic might drive more members of these groups to suicide. Further studies are needed to verify the long-term impact of the COVID-19 pandemic on suicide.
Collapse
Affiliation(s)
- Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Hee Jung Nam
- Department of Psychiatry, Seoul Medical Center, Seoul, Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Korea
- * E-mail:
| |
Collapse
|
5
|
Kim H, Jhon M, Kim JW, Kang HJ, Ryu S, Kim JM, Lee JY, Kim SW. Factors Associated With Depression and Anxiety in Korean Adolescents During the COVID-19 Pandemic. Psychiatry Investig 2022; 19:551-561. [PMID: 35903057 PMCID: PMC9334801 DOI: 10.30773/pi.2021.0365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 06/02/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study was performed to identify factors associated with depression and anxiety among Korean adolescents during the coronavirus disease (COVID-19) pandemic. METHODS We conducted a cross-sectional study of 1,898 Korean adolescents (55.2% male, 44.8% female) ranging in age from 12 to 17 years (mean±standard deviaion age, 15.4±2.6 years). Depression and anxiety were defined as a Patient Health Questionnaire-9 score ≥10 and Generalized Anxiety Disorder-7 score ≥10, respectively. Other questionnaires included sociodemographic data, psychosocial stresses, and experiences in association with COVID-19. Psychiatric scales included Gratitude Questionnaire-6, Perceived Stress Scale-10, and UCLA Loneliness Scale-3. RESULTS The prevalence rates of depressive and anxiety symptoms among participants were 13.8% and 21.0%, respectively. Multivariable logistic regression analysis revealed that female sex, fear of COVID-19 infection, low gratitude were risk factors for depression. Fear of COVID-19 infection, increased TV watching time, and academic-related stress were risk factors for anxiety. CONCLUSION Depression and anxiety were prevalent during the pandemic in Korean adolescents, and were associated with fear of COVID-19 infection. Providing appropriate information on COVID-19, helping adolescents manage academic-related stress and maintain daily life patterns, and implementing interventions to foster gratitude are important for preventing depression and anxiety in Korean adolescents.
Collapse
Affiliation(s)
- Honey Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwangju Bukgu Community Mental Health and Welfare Center, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwangju Bukgu Community Mental Health and Welfare Center, Gwangju, Republic of Korea
| |
Collapse
|
6
|
Lee YR, Chung YC, Kim JJ, Kang SH, Lee BJ, Lee SH, Lee J, Jung HR, Hyun J, Jhon M, Kim JW, Ryu S, Lee JY, Kim JM, Kim SW. Effects of COVID-19-related stress and fear on depression in schizophrenia patients and the general population. NPJ SCHIZOPHRENIA 2022; 8:15. [PMID: 35249110 PMCID: PMC8897617 DOI: 10.1038/s41537-022-00213-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/11/2022] [Indexed: 01/04/2023]
Abstract
This study compared the coronavirus disease 2019 (COVID-19)-related stress, fear of infection, loneliness, and depression between patients with schizophrenia and the general population. A face-to-face survey was administered to 1340 patients with a schizophrenia spectrum disorder and online survey of the general population (n = 2000) was conducted. The information gathered included the level of COVID-19-related stress, fear of infection, the Patient Health Questionnaire-9 score, and the three-item UCLA Loneliness Scale score. Structural equation modeling revealed a significant effect of fear of COVID-19 infection on depression among the general population and on loneliness among patients with schizophrenia. Loneliness experienced during COVID-19 exacerbated depression in both groups. In the COVID-19-related stress-loneliness-depression pathway, the partial mediating effect of loneliness was significant in both groups. Conversely, in the COVID-19-related fear-loneliness-depression pathway, the full mediating effect of loneliness was only significant in patients with schizophrenia. In conclusion, the loneliness associated with COVID-19-related stress and fear of infection was an important factor influencing depression, and the impact was greater in patients with schizophrenia compared with the general population. Thus, different mental health intervention plans are needed for patients with schizophrenia during the COVID-19 pandemic. During the long-lasting COVID-19 pandemic, social support and provision of mental health services to prevent loneliness and consequent depression are required in patients with schizophrenia.
Collapse
Affiliation(s)
- Yu-Ri Lee
- Department of Social Welfare, Nambu University, Gwangju, Korea
| | - Young-Chul Chung
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea
| | - Jung Jin Kim
- Department of Psychiatry, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
| | - Shi Hyun Kang
- Department of Social Psychiatry and Rehabilitation, National Center for Mental Health, Seoul, Korea
| | - Bong Ju Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University College of Medicine, Goyang, Korea
| | - Jonghun Lee
- Department of Psychiatry, Catholic University of Daegu, College of Medicine, Daegu, Korea.,Daegu Metropolitan Mental Health and Welfare Center, Daegu, Korea
| | - Ha-Ran Jung
- Department of Psychiatry, Naju National Hospital, Naju, Korea
| | - Jinhee Hyun
- Department of Social Welfare, College of Social Sciences, Daegu University, Gyeongsan, Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea. .,Mindlink, Gwangju Bukgu Community Mental Health Center, Gwangju, Korea.
| |
Collapse
|
7
|
Ryu S, Nam HJ, Baek SH, Jhon M, Kim JM, Kim SW. Decline in Hospital Visits by Patients with Schizophrenia Early in the COVID-19 Outbreak in Korea. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2022; 20:185-189. [PMID: 35078961 PMCID: PMC8813312 DOI: 10.9758/cpn.2022.20.1.185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 12/30/2022]
Abstract
Objective This study investigated trends in hospital utilization by patients with schizophrenia during the first wave of the COVID-19 outbreak in Korea. Methods The Prophet algorithm was used to predict the monthly number of patients with schizophrenia in 2020 based on medical insurance data between 2010 and 2019. The projected expectations were compared with the actual number of patients receiving outpatient and inpatient treatment each month in the first half of 2020. We conduct interrupted time series analyses of short-term data to determine the significance of recent changes in the trend of hospital visits by patients with schizophrenia. Results The prediction model showed that the actual number of patients receiving treatment each month during the early COVID-19 outbreak decreased by up to 3.6% compared to the projected expectations. The interrupted time series model also revealed a significant change in hospital utilization compared to the year before the onset of COVID-19 in Korea (F = 8.961, p = 0.010). Conclusion This suggests that many patients with schizophrenia were not receiving adequate treatment during the COVID-19 outbreak. A strategy should be developed to keep treating patients with schizophrenia during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Hee Jung Nam
- Department of Psychiatry, Seoul Medical Center, Seoul, Korea
| | - Seon-Hwa Baek
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.,Gwangju Mental Health and Welfare Commission, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.,Gwangju Mental Health and Welfare Commission, Gwangju, Korea
| |
Collapse
|
8
|
Kim Y, Kwon HY, Lee S, Kim CB. Depression During COVID-19 Quarantine in South Korea: A Propensity Score-Matched Analysis. Front Public Health 2022; 9:743625. [PMID: 35155331 PMCID: PMC8828656 DOI: 10.3389/fpubh.2021.743625] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/31/2021] [Indexed: 12/12/2022] Open
Abstract
BackgroundQuarantine, a public health measure used to control the coronavirus disease 2019 (COVID-19) pandemic, has been linked to an increased risk of developing adverse psychological sequelae. This study sought to investigate whether quarantining during the COVID-19 pandemic was associated with depression among Koreans.MethodsData were obtained from the Seoul COVID-19 Study of Quarantine (SCS-Q) and the 2019 Korea Community Health Survey (KCHS). Using propensity scores estimated based on sociodemographic and health conditions, 919 individuals undergoing quarantine in the SCS-Q were matched with 919 individuals who did not experience quarantine in the 2019 KCHS. Depressive symptoms were measured using the Korean version of the Patient Health Questionnaire-9 (PHQ-9), where major depression is defined as a PHQ-9 score ≥ 10. Logistic regression models were adjusted for sociodemographic and health-related factors.ResultsDepression prevalence was higher in quarantined individuals than in the control group (7.8 vs. 3.8%, p < 0.001). Logistic regression analyses revealed that quarantining was associated with higher likelihoods of having major depression [odds ratio (OR) = 2.28, 95% confidence interval (CI): 1.49, 3.51] after adjusting for relevant covariates.LimitationsDue to the online nature of the SCS-Q, this study included a limited number of elderly participants, limiting the generalizability of the findings to the general Korean population.ConclusionsThe findings suggest that Koreans undergoing COVID-19 quarantine are at higher risk of depression. While further investigation is warranted, public health measures to control infectious disease outbreaks, such as quarantine, would benefit from incorporating strategies to address unintended adverse psychological effects, such as depression.
Collapse
Affiliation(s)
- Yongjoo Kim
- College of Korean Medicine, Sangji University, Wonju, South Korea
| | - Hye-Young Kwon
- Division of Biology and Public Health, Mokwon University, Daejeon, South Korea
- *Correspondence: Hye-Young Kwon
| | - Seungyoung Lee
- College of Nursing, Kyunghee University, Seoul, South Korea
| | | |
Collapse
|
9
|
Jang H, Park AL, Lee YR, Ryu S, Lee JY, Kim JM, Kim SW, Kang YS. Relationship Between Economic Loss and Anxiety During the Coronavirus Disease 2019 Pandemic: Moderating Effects of Knowledge, Gratitude, and Perceived Stress. Front Psychiatry 2022; 13:904449. [PMID: 35770062 PMCID: PMC9234110 DOI: 10.3389/fpsyt.2022.904449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/25/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The prolonged coronavirus disease 2019 (COVID-19) pandemic has caused individuals to suffer economic losses, in particular due to the implementation of intensive quarantine policies. Economic loss can cause anxiety and has a negative psychological impact on individuals, worsening their mental health and satisfaction with life. We examined the protective and risk factors that can influence the relationship between economic loss and anxiety during the COVID-19 pandemic. METHODS Panel data from 911 participants were collected in April and May 2020 and again 6 months later. We analyzed the relationship between economic loss and anxiety and investigated the moderating effects of knowledge about COVID-19, gratitude, and perceived stress. Moreover, we investigated whether there were any changes in moderating effects over time or in different demographic groups. RESULTS In the early stages of the spread of COVID-19, gratitude (B = -0.0211, F = 4.8130, p < 0.05) and perceived stress (B = 0.0278, F = 9.3139, p < 0.01) had moderating effects on the relationship between economic loss and anxiety. However, after 6 months, only perceived stress had a significant moderating effect (B = 0.0265, F = 7.8734, p < 0.01). CONCLUSION In the early stages of COVID-19, lower levels of gratitude and higher perceived stress led to greater anxiety. In later stages of the prolonged pandemic, only perceived stress had a continued moderating effect on the relationship between economic loss and anxiety. This study suggests that psychological interventions to reduce perceived stress are needed to treat the possible adverse effects of the spread of infectious diseases on mental health.
Collapse
Affiliation(s)
- Hyerim Jang
- Department of Psychology, Chonnam National University, Gwangju, South Korea
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Yu-Ri Lee
- Department of Social Welfare, Nambu University, Gwangju, South Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea.,Mindlink, Gwangju Bukgu Mental Health and Welfare Center, Gwangju, South Korea
| | - Young-Shin Kang
- Department of Psychology, Chonnam National University, Gwangju, South Korea
| |
Collapse
|
10
|
Lee JY, Kim M, Jhon M, Kim H, Kang HJ, Ryu S, Kim JM, Kim SW. The association of gratitude with perceived stress among nurses in Korea during COVID-19 outbreak. Arch Psychiatr Nurs 2021; 35:647-652. [PMID: 34861959 PMCID: PMC8530766 DOI: 10.1016/j.apnu.2021.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/23/2021] [Accepted: 10/18/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, nurses might experience added emotional stress. This study examined the relationship between gratitude and psychological stress to explore effective psychological support among nurses. METHODS A cross-sectional survey assessed the level of psychological distress in 646 nurses in Gwangju, South Korea, using the Perceived Stress Scale-10 (PSS-10), Gratitude Questionnaire-6 (K-GQ-6), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Maslach Burnout Inventory-General Survey (MBI-GS). Sociodemographic factors and COVID-19-related experiences were also examined. A linear regression model was used to determine the factors influencing perceived stress. RESULTS The mean PSS-10 score was 19.0 ± 4.4. Linear regression analyses revealed that the MBI-GS-Exhaustion, PHQ-9, and GAD-7 scores were positively associated with perceived stress, while the MBI-GS-Professional efficacy score was inversely associated with perceived stress. Gratitude disposition using the K-GQ-6 score negatively predicted PSS-10 (β = 0.829, p < 0.001). CONCLUSIONS Psychological interventions that help cultivate gratitude and professional efficacy among nurses can help promote stress resilience throughout the course of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea; Gwang-ju Mental Health Commission, Gwangju, Republic of Korea
| | - Mina Kim
- Gwang-ju Mental Health Commission, Gwangju, Republic of Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Honey Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea; Gwang-ju Mental Health Commission, Gwangju, Republic of Korea.
| |
Collapse
|
11
|
Kang B, Won J, Kim EJ. COVID-19 Impact on Residential Preferences in the Early-Stage Outbreak in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11207. [PMID: 34769726 PMCID: PMC8582683 DOI: 10.3390/ijerph182111207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/22/2021] [Accepted: 10/23/2021] [Indexed: 11/25/2022]
Abstract
In the early stage of the COVID-19 pandemic in South Korea, public fear or social scaring of urban living was observed, which caused people to change their daily routines. This study examines how the COVID-19 pandemic affected residential choice and perceptions of urban living. We analyzed self-reported survey data collected from 2000 participants in Seoul, Daegu, and Kyeongbuk in South Korea between 3-6 August 2020, targeting the relatively controlled period after the first COVID-19 outbreak. Logistic regression models were used to examine concerns of urban living and residence relocation consideration. Those who were aged 30 or older, regularly commuting, not feeling healthy, with a household size of two, and living in a low-rise condominium were more likely to be concerned with urban living. Those who were aged 40 or older and living in a townhouse or a single-detached house were more likely to consider moving to a less dense area. People perceived that their daily routine changed substantially after the pandemic. Certain participant groups showed concerns of urban living and relocation consideration, suggesting housing policy implications.
Collapse
Affiliation(s)
- Bumjoon Kang
- College of Architecture, Myongji University, Yongin 17058, Korea;
| | - Jaewoong Won
- Department of Real Estate, Graduate School of Tourism, Kyung Hee University, Seoul 02447, Korea;
- Department of Smart City Planning and Real Estate, Kyung Hee University, Seoul 02447, Korea
| | - Eun Jung Kim
- Department of Urban Planning, Keimyung University, Daegu 42601, Korea
| |
Collapse
|
12
|
Kim SW, Park IH, Kim M, Park AL, Jhon M, Kim JW, Kang HJ, Ryu S, Lee JY, Kim JM. Risk and protective factors of depression in the general population during the COVID-19 epidemic in Korea. BMC Psychiatry 2021; 21:445. [PMID: 34496823 PMCID: PMC8425318 DOI: 10.1186/s12888-021-03449-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 08/21/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The risk of depression has risen in the general population during the COVID-19 epidemic. This study was conducted to explore risk and protective factors associated with depression among the general population uninfected by COVID-19. METHODS A cross-sectional study was conducted with 1,500 representative South Korean citizens aged 19-65 years through an anonymous online survey. Depression was defined as a Patient Health Questionnaire-9 score of 10 or higher. Other questionnaires included one measuring psycho-behavioural and social changes, and stress, due to COVID-19, a six-item version of the Gratitude Questionnaire (GQ-6), and a three-item version of the UCLA loneliness scale. RESULTS Of the 1492 participants not infected by COVID-19, 312 (20.9%) exhibited depression. Multiple logistic regression analysis revealed that depression was positively associated with COVID-19-related stress and psycho-behavioural variables such as disturbances in eating and sleeping, younger age, smoking, underlying mental illness, and loneliness scale scores. In contrast, exercise three or more times per week and GQ-6 scale scores were inversely associated with depression. CONCLUSION During the COVID-19 pandemic, maintaining daily routines including eating, sleeping, and regular exercise and focusing on gratitude may be important for the prevention of depression. In addition, more attention should be paid to vulnerable populations, including young people, those with mental illnesses, and smokers, who might be more susceptible to depression.
Collapse
Affiliation(s)
- Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea.
- Gwangju Mental Health Commission, Gwangju, Korea.
| | - In-Hoo Park
- Gwangju Mental Health Commission, Gwangju, Korea
| | - Mina Kim
- Gwangju Mental Health Commission, Gwangju, Korea
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
- Gwangju Mental Health Commission, Gwangju, Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea.
| |
Collapse
|
13
|
Abstract
PURPOSE OF REVIEW The paper aims to provide an overview of the psychological and behavioural impacts of the COVID-19 pandemic, with a focus on variations in behavioural response in different geographical areas due to the existence of different social-cultural contexts. RECENT FINDINGS Whilst anxiety, depression and economic stressors are common findings worldwide, specific behavioural responses are heavily influenced by government stances, misinformation, conspiratorialism and competing demands of resource scarcity. This has led to very different understandings of the pandemic even in geographically close areas, and more so when comparing disparate regions such as Africa, South America and Europe. The paper also comments on the absence of robust evidence regarding increases of suicidality and violence on a global level, whilst noting evidence certainly exists in specific regions. SUMMARY The psychological and behavioural impact of COVID is heavily influenced by the local lens. Beyond a very broad brush approaches, expected behaviours from one area cannot easily be extrapolated to others. Where possible, clinicians should be guided by local data, ideally placing expectations of responses in a cultural context.
Collapse
Affiliation(s)
- Kevin Kendrick
- Department of Psychiatry, Bunbury Hospital, Western Australian Country Health Service, Upper South West Mental Health Team, Bunbury
| | - Mohan Isaac
- University of Western Australia, Department of Psychiatry, Fremantle Hospital, South Metropolitan Health Service, Fremantle
- Division of Psychiatry, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
14
|
Lee JY, Kim M, Jhon M, Kim JW, Ryu S, Kim JM, Kim SW. Factors Associated With a Negative Emotional Response to News Media and Nationwide Emergency Text Alerts During the COVID-19 Outbreak in Korea. Psychiatry Investig 2021; 18:825-830. [PMID: 34500508 PMCID: PMC8473856 DOI: 10.30773/pi.2021.0087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/01/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To prevent the spread of infection in Korea during the corona virus disease 2019 (COVID-19) outbreak, real-time warnings have been sent to all residents via mobile phones. This study examined the factors associated with the negative emotional response to media news and emergency text alerts in the COVID-19 pandemic. METHODS A survey was completed by 1,500 adults from an online public panel in three regions. We used Patient Health Questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Perceived Stress Scale-10 (PSS-10) to assess the level of depression, anxiety and stress, respectively. Questionnaires related to COVID-19 included fear of infection, and fear of disclose of contact-tracing information. RESULTS The negative emotional response on both news media information and emergency alert text messages about COVID-19 was associated with fear of COVID-19 infection and high anxiety. The biggest outbreak city, Daegu was associated with the less negative emotional response on emergency alert text messages. Fear of disclose of contact-tracing information was significantly associated with negative emotional perception on emergency alter text messages. CONCLUSION Our results suggest that effective information providing services with considering vulnerable groups are needed to promote acceptance and eliminate negative emotion for disease related information.
Collapse
Affiliation(s)
- Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwang-ju Mental Health Commission, Gwangju, Republic of Korea
| | - Mina Kim
- Gwang-ju Mental Health Commission, Gwangju, Republic of Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwang-ju Mental Health Commission, Gwangju, Republic of Korea
| |
Collapse
|
15
|
OJEWALE LUCIAYETUNDE. Psychological state, family functioning and coping strategies among undergraduate students in a Nigerian University during the COVID-19 lockdown. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E285-E295. [PMID: 34604567 PMCID: PMC8451335 DOI: 10.15167/2421-4248/jpmh2021.62.2.1798] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 04/04/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The curtailment of social gatherings and the lack of online academic engagement during the COVID-19 lockdown could have potentially damaging effects on the psychological state of university students in Nigerian public universities. This study examined the prevalence of anxiety and depression, including associated factors and coping methods, among undergraduate students. METHODS This cross-sectional study, which involved 386 undergraduate students, was assigned approval number UI/EC/20/0242. An online questionnaire consisting mainly of the Hospital Anxiety and Depression Scale and the McMaster Family Assessment Device was circulated among the students. The results were analysed by means of descriptive statistics, chi-square, Analysis of Variance (ANOVA) and linear logistical regression, at α 0.05. RESULTS Mean age was 21 ± 2.9 years, with females constituting 60.1% of the sample. The prevalence rates of anxiety and depression were 41.5 and 31.9%, respectively. Students in health-related faculties were significantly less anxious than others. Inability to afford three square meals, negative family functioning, chronic illness and living in a State/Region with a high incidence of COVID-19 were significantly associated with depression. These factors jointly accounted for 14% of depression. Coping methods included the use of social media, watching movies and participating in online skills-development programs. CONCLUSION The overall level of anxiety and depression among undergraduate students during the COVID-19 lockdown was higher than the levels previously reported. Inadequate nutrition and poor family functioning contributed significantly to this. Proactive measures ought to be taken to support undergraduate students in order to prevent the negative consequences of poor mental health.
Collapse
Affiliation(s)
- LUCIA YETUNDE OJEWALE
- Department of Nursing, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| |
Collapse
|
16
|
Shields C, Bernard J, Mirza OI, Reeves D, Wells A, Heagerty A. Covid-19, Lockdown and Self-Isolation: Evaluation of Deliberate Self-Harm Admissions. Front Psychiatry 2021; 12:662885. [PMID: 34079485 PMCID: PMC8165941 DOI: 10.3389/fpsyt.2021.662885] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/19/2021] [Indexed: 01/07/2023] Open
Abstract
Background: COVID 19 is still presenting a clear and dynamic global threat. The United Kingdom remains one of the hardest hit countries from the pandemic. In January 2021 parliament announced that the UK will be entering a full national lockdown. This paper explores what effect lockdown measures had on rates of deliberate self-harm presentations to one NHS trust in Manchester UK. Methods: This paper compared the number of cases of deliberate self-harm which presented to the emergency department of Manchester Royal Infirmary for March-May in 2018, 2019 and 2020. This was achieved by utilising coding from emergency department data and reviewing hospital records surrounding each case. Results: 2018 recorded a total of 101 admissions as a result of DSH with all causes admissions of 8,514 making the proportions of admissions due to self-harm 1.19%. In 2019, 9,038 patients were admitted, of these, 130 (1.44%) were identified as DSH. In 2020 the total number of admissions fell to 5,676 with 118 admitted due to self-harm, representing 2.08% of admissions. The absolute number of admissions remained stable however the proportion of admissions due to self-harm was significantly higher in 2020 (p < 0.001). Other significant findings include a higher proportion of male admissions compared to females in 2020 (58.5%) and a decrease in the normal of cases relating to paracetamol overdose in 2020. Discussion: The findings demonstrated by this study do not indicate that lockdown is an absolute risk for DSH behaviours however it does illustrate the stable nature of these cases despite and dramatic decline in all cause admissions. The rate of increase of deliberate self-harm accelerated significantly between March and May in 2020. Steps must be taken to avoid a similar situation following the 2021 lockdown and beyond - focus on improving access to certain virtual services may help to achieve this goal.
Collapse
Affiliation(s)
- Callum Shields
- Manchester University Foundation Trust, Manchester, United Kingdom
| | - Jack Bernard
- Manchester University Foundation Trust, Manchester, United Kingdom
| | - Omer Idris Mirza
- Manchester University Foundation Trust, Manchester, United Kingdom
| | - David Reeves
- Division of Population Health, Health Services Research and Primary Care, Manchester, United Kingdom
| | - Adrian Wells
- School of Psychological Science, Section of Clinical and Health Psychology University of Manchester Rawnsley Building, Manchester, United Kingdom
| | - Anthony Heagerty
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester Core Technology Facility, Manchester, United Kingdom
| |
Collapse
|
17
|
Jung HR, Park C, Kim M, Jhon M, Kim JW, Ryu S, Lee JY, Kim JM, Park KH, Jung SI, Yoon BH, Kim SW. Factors associated with mask wearing among psychiatric inpatients during the COVID-19 pandemic. Schizophr Res 2021; 228:235-236. [PMID: 33476952 PMCID: PMC7831677 DOI: 10.1016/j.schres.2020.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/14/2020] [Accepted: 12/28/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Ha-Ran Jung
- Department of Psychiatry, Naju National Hospital, Naju, South Korea
| | - Cheol Park
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Mina Kim
- Gwangju Mental Health and Welfare Commission, Gwangju, South Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea
| | - Kyung-Hwa Park
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, South Korea
| | - Sook-In Jung
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, South Korea
| | - Bo-Hyun Yoon
- Department of Psychiatry, Naju National Hospital, Naju, South Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea; Gwangju Mental Health and Welfare Commission, Gwangju, South Korea.
| |
Collapse
|
18
|
Lee YR, Lee JY, Park IH, Kim M, Jhon M, Kim JW, Ryu S, Kim JM, Kim SW. The Relationships among Media Usage Regarding COVID-19, Knowledge about Infection, and Anxiety: Structural Model Analysis. J Korean Med Sci 2020; 35:e426. [PMID: 33316862 PMCID: PMC7735916 DOI: 10.3346/jkms.2020.35.e426] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/24/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND We examined the effects of mass media usage on people's level of knowledge about coronavirus disease 2019 (COVID-19), fear of infection, prejudice towards infected people, and anxiety level. In addition, we investigated whether knowledge about COVID-19 can reduce fear, prejudice, and anxiety. METHODS We performed an anonymous online survey in 1,500 residents aged 19-65 years between April 24 and May 5 of 2020. Anxiety level was assessed using the generalized anxiety disorder-7 scale. We used a questionnaire to investigate COVID-19-related media use, knowledge about COVID-19, fear of infection, and prejudice towards infected people. We analyzed the relationships among the variables using the structural equation model. RESULTS Media use had significant effects on fear of infection, prejudice against infected people, and anxiety. Knowledge about COVID-19 had a significant protective effect on fear of infection, prejudice against infected people, and anxiety. However, the effect of media use on knowledge about COVID-19 was not statistically significant. There was a partial mediating effect of prejudice against infected people and fear of infection on media usage and anxiety. CONCLUSION Our study demonstrated significant effects of mass media coverage regarding COVID-19 on fear, prejudice, and anxiety. While knowledge about COVID-19 could decrease fear, prejudice, and anxiety, the use of mass media did not enhance this knowledge. Medical societies should guide mass media reporting of COVID-19 and provide appropriate public education.
Collapse
Affiliation(s)
- Yu Ri Lee
- Department of Social Welfare, Nambu University, Gwangju, Korea
- Gwangju Mental Health and Welfare Commission, Gwangju, Korea
| | - Ju Yeon Lee
- Gwangju Mental Health and Welfare Commission, Gwangju, Korea
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - In Hoo Park
- Gwangju Mental Health and Welfare Commission, Gwangju, Korea
| | - Mina Kim
- Gwangju Mental Health and Welfare Commission, Gwangju, Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Seunghyong Ryu
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung Wan Kim
- Gwangju Mental Health and Welfare Commission, Gwangju, Korea
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
| |
Collapse
|