Development of Mental Health Indicators in Korea

Objective: Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea. Methods: This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries. Results: We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders. Conclusion: Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation

Sociodemographic factors associated with the use of mental health services in depressed adults: results from the Korea National Health and Nutrition Examination Survey (KNHANES)

Background: The aims of this study were to determine the utilization of mental health services (MHSs) by adults with a depressive mood and to identify the influencing sociodemographic factors, using a nationwide representative Korean sample. Methods: The study included 2735 subjects, aged 19 years or older, who had experienced a depressive mood continuously for over 2 weeks within the previous year, using the data from the KNHANES IV (Fourth Korea National Health and Nutrition Examination Survey), which was performed between 2007 and 2009, and involved a nationally representative sample of the Korean community population who were visited at home. A multivariate logistic regression analysis was used to estimate the adjusted odd ratios (ORs) and 95% confidence intervals (CIs) for the use of MHSs, which was defined as using healthcare institutions, consulting services, and inpatient or outpatient treatments due to mental health problems. Results: MHSs had been used by 9.6% of the subjects with a depressive mood. The use of the MHSs was significantly associated with age, education level, and employment status, after adjusting for sociodemographic and health-related factors. Specifically, the OR for the nonuse of MHSs by the elderly (≥65 years) relative to subjects aged 19–34 years was 2.55 (95% CI = 1.13–5.76), subjects with a lower education level were less likely to use MHSs compared to those with a higher education level (7–9 years, OR = 2.35, 95% CI = 1.19–4.64; 10–12 years, OR = 1.66, 95% CI = 1.07–2.56; ≥13 years, reference), and the OR of unemployed relative to employed was 0.47 (95% CI = 0.32–0.67). Conclusions: Among Korean adults with a depressive mood, the elderly, those with a lower education level, and the employed are less likely to use MHSs. These findings suggest that mental health policies should be made based on the characteristics of the population in order to reduce untreated patients with depression. Greater resources and attention to identifying and treating depression in older, less educated, and employed adults are warranted

Increased Transforming Growth Factor-beta1 in Alcohol Dependence

Ethanol and its metabolite acetaldehyde increase transforming growth factor beta1 (TGF-β1) expression in animal studies. TGF-β1 is related with the hepatic stellate cell (the key element of hepatic fibrogenesis) and the radial glia (the key element of neuronal migration). Blood samples were collected from 41 patients with alcohol dependence, TGF-β1 levels measured by ELISA were compared with 41 normal subjects. Plasma TGF-β1 levels in the patients with alcohol dependence (1,653.11±532.45 pg/mL) were significantly higher than those of healthy subjects (669.87±366.53 pg/mL) (P=0.000). Patients with or without liver pathology showed no difference in TGF-β1 (P=0.36). Increased TGF-β1 may mediate deleterious effect of alcohol such as hepatic fibrosis and suppressed neuronal developments in alcohol dependence patients

Alcohol-Induced Blackout

For a long time, alcohol was thought to exert a general depressant effect on the central nervous system (CNS). However, currently the consensus is that specific regions of the brain are selectively vulnerable to the acute effects of alcohol. An alcohol-induced blackout is the classic example; the subject is temporarily unable to form new long-term memories while relatively maintaining other skills such as talking or even driving. A recent study showed that alcohol can cause retrograde memory impairment, that is, blackouts due to retrieval impairments as well as those due to deficits in encoding. Alcoholic blackouts may be complete (en bloc) or partial (fragmentary) depending on severity of memory impairment. In fragmentary blackouts, cueing often aids recall. Memory impairment during acute intoxication involves dysfunction of episodic memory, a type of memory encoded with spatial and social context. Recent studies have shown that there are multiple memory systems supported by discrete brain regions, and the acute effects of alcohol on learning and memory may result from alteration of the hippocampus and related structures on a cellular level. A rapid increase in blood alcohol concentration (BAC) is most consistently associated with the likelihood of a blackout. However, not all subjects experience blackouts, implying that genetic factors play a role in determining CNS vulnerability to the effects of alcohol. This factor may predispose an individual to alcoholism, as altered memory function during intoxication may affect an individual’s alcohol expectancy; one may perceive positive aspects of intoxication while unintentionally ignoring the negative aspects. Extensive research on memory and learning as well as findings related to the acute effects of alcohol on the brain may elucidate the mechanisms and impact associated with the alcohol-induced blackout

Prediction of major depressive disorder following beta-blocker therapy in patients with cardiovascular diseases

Incident depression has been reported to be associated with poor prognosis in patients with cardiovascular disease (CVD), which might be associated with beta-blocker therapy. Because early detection and intervention can alleviate the severity of depression, we aimed to develop a machine learning (ML) model predicting the onset of major depressive disorder (MDD). A model based on L1 regularized logistic regression was trained against the South Korean nationwide administrative claims database to identify risk factors for the incident MDD after beta-blocker therapy in patients with CVD. We identified 50,397 patients initiating beta-blockers for CVD, with 774 patients developing MDD within 365 days after initiating beta-blocker therapy. An area under the receiver operating characteristic curve (AUC) of 0.74 was achieved. A history of non-selective beta-blockers and factors related to anxiety disorder, sleeping problems, and other chronic diseases were the most strong predictors. AUCs of 0.62–0.71 were achieved in the external validation conducted on six independent electronic health records and claims databases in the USA and South Korea. In conclusion, an ML model that identifies patients at high-risk for incident MDD was developed. Application of ML to identify susceptible patients for adverse events of treatment may serve as an important approach for personalized medicine

Scientific Evidence for the Addictiveness of Tobacco and Smoking Cessation in Tobacco Litigation

Smokers keep smoking despite knowing that tobacco claims many lives, including their own and others’. What makes it hard for them to quit smoking nonetheless? Tobacco companies insist that smokers choose to smoke, according to their right to self-determination. Moreover, they insist that with motivation and willpower to quit smoking, smokers can easily stop smoking. Against this backdrop, this paper aims to discuss the addictive disease called tobacco use disorder, with an assessment of the addictiveness of tobacco and the reasons why smoking cessation is challenging, based on neuroscientific research. Nicotine that enters the body via smoking is rapidly transmitted to the central nervous system and causes various effects, including an arousal response. The changes in the nicotine receptors in the brain due to continuous smoking lead to addiction symptoms such as tolerance, craving, and withdrawal. Compared with other addictive substances, including alcohol and opioids, tobacco is more likely to cause dependence in smokers, and smokers are less likely to recover from their dependence. Moreover, the thinning of the cerebral cortex and the decrease in cognitive functions that occur with aging accelerate with smoking. Such changes occur in the structure and functions of the brain in proportion to the amount and period of smoking. In particular, abnormalities in the neural circuits that control cognition and decision-making cause loss of the ability to exert self-control and autonomy. This initiates nicotine dependence and the continuation of addictive behaviors. Therefore, smoking is considered to be a behavior that is repeated due to dependence on an addictive substance, nicotine, instead of one’s choice by free will

Integrated Multiwavelength Semiconductor Lasers

159 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 2000.The next technical challenge is to increase the number of lasing modes with as much control over the wavelength and linewidth as in today's single-wavelength semiconductor lasers. By utilizing multiple sections of periodic structures, dual-wavelength InGaAs-GaAs ridge waveguide semiconductor lasers have been fabricated. Not only do these dual-wavelength lasers operate at predetermined wavelengths, but the wavelength separations between the two lasing modes can be tuned electronically.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD