To develop a pediatric research agenda focused on pediatric healthcare-associated infections and antimicrobial stewardship topics that will yield the highest impact on child health.

The study included 26 geographically diverse adult and pediatric infectious diseases clinicians with expertise in healthcare-associated infection prevention and/or antimicrobial stewardship (topic identification and ranking of priorities), as well as members of the Division of Healthcare Quality and Promotion at the Centers for Disease Control and Prevention (topic identification).

Using a modified Delphi approach, expert recommendations were generated through an iterative process for identifying pediatric research priorities in healthcare associated infection prevention and antimicrobial stewardship. The multistep, 7-month process included a literature review, interactive teleconferences, web-based surveys, and 2 in-person meetings.

A final list of 12 high-priority research topics were generated in the 2 domains. High-priority healthcare-associated infection topics included judicious testing for Clostridioides difficile infection, chlorhexidine (CHG) bathing, measuring and preventing hospital-onset bloodstream infection rates, surgical site infection prevention, surveillance and prevention of multidrug resistant gram-negative rod infections. Antimicrobial stewardship topics included β-lactam allergy de-labeling, judicious use of perioperative antibiotics, intravenous to oral conversion of antimicrobial therapy, developing a patient-level “harm index” for antibiotic exposure, and benchmarking and or peer comparison of antibiotic use for common inpatient conditions.

We identified 6 healthcare-associated infection topics and 6 antimicrobial stewardship topics as potentially high-impact targets for pediatric research.

This is the first report on the association between trauma exposure and depression from the Advancing Understanding of RecOvery afteR traumA(AURORA) multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience.

We focus on participants presenting at EDs after a motor vehicle collision (MVC), which characterizes most AURORA participants, and examine associations of participant socio-demographics and MVC characteristics with 8-week depression as mediated through peritraumatic symptoms and 2-week depression.

Eight-week depression prevalence was relatively high (27.8%) and associated with several MVC characteristics (being passenger v. driver; injuries to other people). Peritraumatic distress was associated with 2-week but not 8-week depression. Most of these associations held when controlling for peritraumatic symptoms and, to a lesser degree, depressive symptoms at 2-weeks post-trauma.

These observations, coupled with substantial variation in the relative strength of the mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated in more in-depth analyses of the rich and evolving AURORA database to find new targets for intervention and new tools for risk-based stratification following trauma exposure.

There have been many changes in the treatment of bipolar disorder.

It is necessary to develop guidelines that can more aptly respond to cultural issues and specifics in different countries.

The Korean Medication Algorithm for Bipolar Disorder (KMAP-BP) was firstly published in 2002, with updates in 2006 and 2010. This third update reviewed the experts' consensus of opinion on the pharmacological treatments of bipolar disorder.

The newly revised questionnaire composed of 55 key questions about clinical situations including 223 sub-items was sent to the experts.

Combination of mood stabilizer (MS) and atypical antipsychotic (AAP) was the first-line treatment option in acute mania. For the management of severe psychotic bipolar depression, combination of MS and AAP, combination of AAP and LTG, combination of MS, AAP and AD or LTG, combination of AAP and AD, and combination of AAP, AD and LTG was the first-line treatments. Combination of MS and AAP was the treatment of choice for management of mixed features. Combination of MS and AAP, MS or AAP monotherapy was the first-line options for management of maintenance phase after manic episode. For maintenance treatment after bipolar I depression, combination of MS and AAP, combination of MS and LTG, combination of AAP and LTG, MS or LTG monotherapy, and combination of MS, AAP and LTG were the first-line options.

Despite the limitations of expert consensus guideline, KMAP-BP 2014 may reflect the current patterns of clinical practice and recent researches.

This cross-sectional study was aimed to investigate the factors associated with bipolar disorder in pregnant female, including sociodemographic parameters, social support, social conflict, suicidal idea and sleep.

A total of 84 pregnant female were recruited. They filled out self-completing questionnaires on sociodemographic factors, obstetric history, depressive symptoms and bipolarity. Depressive symptoms were assessed using the Korean version of the Edinburgh Postnatal Depression Scale (EPDS). Bipolarity was assessed using the Korean version of the Mood Disorder Questionnaire (K-MDQ).

Nineteen participants (22.6%) had positive K-MDQ scores, suggesting the present of bipolarity. Positive EPDS group had twenty subjects (25%) who had depressive symptoms. The diathesis of bipolar disorder was associated with marital dissatisfaction, social conflict, depression and sleep. The multiple logistic regression analysis revealed that the only poor sleep was a risk of bipolarity.

Pregnant female with bipolarity were more depressed and sleep problems than those without bipolarity. The results showed that the most important factor of influencing bipolarity was sleep.

This study aimed to explore thedifference in emotional recognition of musical auditory stimulation and artfulvisual stimulation between helathy people and patients with schizophrenia.

20 songs and 20 paintings thatcontained sad or cheerful emotions were presented to 123 patients withschizophrenia and 224 healthy people as control group. The subjects were askedto tell about their emotions that they had felt from each musical auditorystimulation and artful visual stimulation. To measure such emotions, the Emotional Empathy Scale was used. The level of psychopathology in patientsgroup were evaluated with the Positive and Negative Syndrome Scale and the Formal Thought Disorder Rating Scale.

The correct answer rate to musical auditoryand artful visual stimulation of the patient group was significantly lower than that of thecontrol group. Thepatient group showed lower emotional empathic ability compared to the controlgroup. In the patient group, the correct answer rate to musical and artfulstimulation showed a negative correlation with score with Formal ThoughtDisorder Rating Scale.

Patients with schizophrenia have difficulties inprecise emotional recognition to auditory and visual stimulations, and this isassociated with lowered empathic ability and thinking disorder of patients withschizophrenia. If an psychosocial rehabilitation program or psychotherapy isimplemented to patients with schizophrenia, it is deemed to be necessary to make a mediation to improve the emotional recognition and expression ability of patients with schizophrenia.

This study was aimed to discover the correlation between those getting tattoos and their psychopathology relating to their delinquent behavior and emotional problems.

Date for this study was collected from 19-year-old men who were receiving a physical examination for conscription at the Korea Military Manpower Administration. 400 data sheets were collected among them. All of sjubjects were evaluated on the following measures: sociodemographic variants, Juvernile delinquency scale, State-trait anger expression inventory, Beck depression inventory, State-triat anxiety inventory, and Positive affect and negative affect schedule.

In comparison with those without tattooes, those with a tattoo scored higher in the scales that were related to delinquency, anger, depression, and negateive emotion. Furthermore, there were positive correlations between the number of tattoos and the scores for the Juvenile delinquent tendency and behavior scale as well as on the State-triat anxiety scale.

Those with tattoos had experienced anger, anxiety, and depression more strongly in comparison with those without tattoos. These reults recommended that tattooed males should be evaluated more on their regrading psychopathology compared to those without tattoos.

The aim of this study was to monitor changes of prescription trends for bipolar disorder in inpatient settings in one university hospital.

A retrospective chart review was performed and data of 188 cases (2009–2012) and 118 cases (1998–2001) with a diagnosis of bipolar disorder were collected. Data on demographic variables, duration of hospitalization, kinds of psychotropic medications and the patterns of prescription over each four-year period were analyzed.

The proportion of patients with manic episode was decreased, whereas those of mixed and depressive episodes were increased. The use of lithium was decreased with the increased use of valproate. Increased use of lamotrigine in depressive episode was prominent. The use of combination treatment with mood stabilizers and antipsychotics was almost same level in both periods. The use of typical antipsychotics was significantly decreased and that of atypical antipsychotics was increased. Especially, the use of quetiapine showed great increase. In bipolar depression, the use of antidepressant was increased.

Data showed that quetiapine monotherapy had favorable effect on acute manic symptoms and well tolerated. Also this result suggests that quetiapine monotherapy may improve the self-perceived quality of sleep without any daytime impairment following sleep in acute manic patients.

Life events and accompanying psychological and behavioral reactions frequently have an impact upon people's daily lives and are believed to predispose them to disease. Psychological stressors impact many physiological and pathological disease outcomes, including mental illness. Positive social interactions have in turn been shown to exert powerful beneficial effects on health outcomes and longevity.

The Objective of this study was to analyze the relationships of Psychological Distress, Social Support, and Mental Fitness among patients of mental health services.

This article aims to discuss the evidence supporting the mediating effect of social support between psychological stress and mental health.

This study was performed on patients who visited the mental health services in Daejeon from October to December 2011. In total, 395 patients were evaluated with Mental Fitness Scale, Kessler Psychological Distress Scale(KPDS), and Multidimensional Scale of Perceived Social Support(MSPSS).

Correlations among variables of psychological distress and social support on subordinate variable of mental fitness of patients were significant. The result of the regression analysis, psychological distress and social support have a positively significant influence on mental fitness of patients. social support showed mediating effects between psychological distress and mental fitness.

These results suggest that health care providers ought to seek social support for patients, in order to provide positive mental fitness of patients.

Despite the advance in pharmacotherapy for posttraumatic stress disorder (PTSD), poor treatment adherence to pharmacotherapy for PTSD is a critical issue.

We intended to evaluate the predictors of premature discontinuation of psychiatric outpatient treatment after discharge for noncombat-related PTSD.

This study aimed to examine the sociodemographic and disease-related variables associated with the premature discontinuation of psychiatric outpatient treatment after discharge among patients with non-combat-related posttraumatic stress disorder.

We retrospectively reviewed the medical records of patients who were discharged with a diagnosis of posttraumatic stress disorder.

Fifty-five percent of subjects prematurely discontinued outpatient treatment within 6 months of discharge. Comparing sociodemographic variables between the 6-month non-follow-up group and 6-month follow-up group, there were no variables that differed between the two groups. However, comparing disease-related variables, the 6-month follow-up group showed a longer hospitalization duration and higher Global Assessment of Function score at discharge. The logistic regression analysis showed that a shorter duration of hospitalization predicted premature discontinuation of outpatient treatment within 6 months of discharge.

The duration of psychiatric hospitalization for posttraumatic stress disorder appeared to influence the premature discontinuation of outpatient treatment after discharge.

This study examined the prescribing patterns for medications to treat bipolar disorder in outpatient-based psychiatric practice focusing on atypical antipsychotics.

Retrospective chart review of patients admitted to a university hospital with a primary diagnosis of bipolar disorder in a period from January 2008 to December 2012 was conducted. We reviewed Diagnostic and Statistical Manual of Mental Disorders, fourth edition diagnosis and detailed clinical information at index episode. Psychotropic medications were grouped into six categories; atypical antipsychotics, typical antipsychotics, lithium, anticonvulsants, antidepressants, and minor tranquilizers. Severity, rapid cycling type, psychiatric comorbidity and disease duration were computed focusing on atypical antipsychotics.

In 344 patients who were prescribed major psychotropic medications, atypical antipsychotics were prescribed in 70.9% of subjects, anticonvulsants in 73.3%, lithium in 36.9%, antidepressants in 41.9%, and typical antipsychotics in 0.9% of subjects. About 12.5% of subjects were treated with the monotherapy. Atypical antipsychotics prescription was favored in subjects with manic and mixed episodes or severe episode. Prescribing trend is independent of rapid cycling type. Prescription of antidepressants were more frequent in subjects who were recently diagnosed as bipolar disorder or prescribed new medications or existed psychiatric comorbidity.

The development of bipolar disorder's psychopharmacology has been reflected in the prescription pattern of psychotropic medications in Korea. This study suggests that atypical antipsychotics have played major role in treatment of bipolar disorder.

The purpose of this study was to evaluate the occurrence of the suicidal ideation and associated factors with self-reported suicidal ideation within the last 12 months among Korean adolescents.

A total of 1533 adolescents were recruited from middle schools (age range: 13-14 years) in Korea. According to existence of suicidal ideation, they were divided 2 group – suicidal ideation group and non-suicidal ideation group, and the differences between groups in terms of various characteristics, including depression (Kovacs’ Children’s Depression Inventory), school and family factors, and health related conditions.

A total of 501 (32.7%) middle school students reported suicidal ideation, and the rate of suicidal attempt was 6.9% (n=106). The associated factors of suicidal ideation were female (OR= 2.42, p<0.001), below average academic achievement (OR=1.43, p=0.007), perceived low parental support (OR=2.09, p=0.001), depression (OR=3.25, p<0.001), current alcohol use (OR=2.37, p=0.003), self reported poor health (OR=1.54, p =0.043), and school bullying (OR=1.91, p =0.005).

These results may have important implications for the strategies and specified intervention in preventing suicidal ideation in Korean adolescents.

We evaluated the difference in sleep skills between patients with and without need of hypnotics after sleep CBT.

Total 131 insomnia patients' sleep disturbances were assessed by visual analogue scales. Patients received 9 sessions of sleep CBT and were prescribed hypnotics for prn during 3 months. Sleep CBT was focused on the sleep hygiene and sleep stimulus-control guidelines. Sleep hygiene guidelines were Limit the time spent in bed (SH1), Get regular exercise (SH2), Avoid light at night (SH3), Avoid heavy meals or drinking (SH4), Quiet, dark, and comfortable bedroom (SH5), Avoid caffeine, alcohol, and nicotine (SH6), Relaxing bedtime routine (SH7),Llight bedtime snack (SH8), Remove the bedroom clock (SH9). Sleep stimulus-control guidelines were Go to bed only when sleepy (SSC1), Use the bed for sleeping or sex (SSC2), Get out of bed when unable to sleep (SSC3), Get up at the same time (SSC4), Avoid napping (SSC5). Each sleep skill state was evaluated by Likert scale, and they were compared between before and after CBT. Patients were divided into two groups: still need of hypnotics and no need of hypnotics after 3 months.

Forty-six (35.1%) patients replied they needed not hypnotics any more, but 85 (64.9%) patients replied they still needed hypnotics after CBT. Sleep VAS (25.26±8.52 vs. 32.64±8.95, p<0.001), SH2 (3.67±0.92 vs. 2.76±1.06, p=0.030), SH7 (4.08±0.55 vs. 2.76±0.76, p<0.001) were different in two groups.

Among several CBT skills, regular moderate exercise in daytime and a relaxing bedtime routine seem to be key components.

To investigate the association between parity and the risk of incident dementia in women.

We pooled baseline and follow-up data for community-dwelling women aged 60 or older from six population-based, prospective cohort studies from four European and two Asian countries. We investigated the association between parity and incident dementia using Cox proportional hazards regression models adjusted for age, educational level, hypertension, diabetes mellitus and cohort, with additional analysis by dementia subtype (Alzheimer dementia (AD) and non-Alzheimer dementia (NAD)).

Of 9756 women dementia-free at baseline, 7010 completed one or more follow-up assessments. The mean follow-up duration was 5.4 ± 3.1 years and dementia developed in 550 participants. The number of parities was associated with the risk of incident dementia (hazard ratio (HR) = 1.07, 95% confidence interval (CI) = 1.02–1.13). Grand multiparity (five or more parities) increased the risk of dementia by 30% compared to 1–4 parities (HR = 1.30, 95% CI = 1.02–1.67). The risk of NAD increased by 12% for every parity (HR = 1.12, 95% CI = 1.02–1.23) and by 60% for grand multiparity (HR = 1.60, 95% CI = 1.00–2.55), but the risk of AD was not significantly associated with parity.

Grand multiparity is a significant risk factor for dementia in women. This may have particularly important implications for women in low and middle-income countries where the fertility rate and prevalence of grand multiparity are high.

Epidemiological studies indicate that individuals with one type of mental disorder have an increased risk of subsequently developing other types of mental disorders. This study aimed to undertake a comprehensive analysis of pair-wise lifetime comorbidity across a range of common mental disorders based on a diverse range of population-based surveys.

The WHO World Mental Health (WMH) surveys assessed 145 990 adult respondents from 27 countries. Based on retrospectively-reported age-of-onset for 24 DSM-IV mental disorders, associations were examined between all 548 logically possible temporally-ordered disorder pairs. Overall and time-dependent hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. Absolute risks were estimated using the product-limit method. Estimates were generated separately for men and women.

Each prior lifetime mental disorder was associated with an increased risk of subsequent first onset of each other disorder. The median HR was 12.1 (mean = 14.4; range 5.2–110.8, interquartile range = 6.0–19.4). The HRs were most prominent between closely-related mental disorder types and in the first 1–2 years after the onset of the prior disorder. Although HRs declined with time since prior disorder, significantly elevated risk of subsequent comorbidity persisted for at least 15 years. Appreciable absolute risks of secondary disorders were found over time for many pairs.

Survey data from a range of sites confirms that comorbidity between mental disorders is common. Understanding the risks of temporally secondary disorders may help design practical programs for primary prevention of secondary disorders.