To substantiate psychological symptoms following humidifier disinfectant (HD) disasters, counseling records of 26 victims and 92 family members of victims (45 were bereaved) were analyzed retrospectively. Among the victims, 34.6% had Clinical Global Impression-Severity scores of over 4, which meant they were moderately ill. While anxiety/fear and depression with respiratory symptoms were frequently observed in victims and family members, chronic psychological distress such as alcohol/smoking abuse and insomnia was relatively high in bereaved family members. In conclusion, it is important to provide mental health support for victims and their families, focusing on the characteristic symptoms of each group as well as monetary compensation.

ObjectiveThis study explores the feasibility and psychometric properties of the Korean version of the Bipolar Depression Rating Scale (BDRS) in adolescents with Early-onset bipolar disorders.MethodsFifty-three participants (aged 13–18) with early-onset bipolar disorders (40 depressed and 18 euthymic, 5 patients were assessed at depressed state and reassessed after remission) were recruited. All participants were assessed using the BDRS, the Hamilton Depression Rating Scale (HAM-D), the Montgomery-Asperg Depression Rating Scale (MADRS), the Young Mania Rating Scale (YMRS), and the Modified Overt Aggression scale (MOAS).ResultsBDRS exhibited good internal validity and significant correlations with the HAM-D and the MADRS. In item to scale correlations, all items on the BDRS were significantly correlated with the BDRS total scores except for ‘increased motor drive’ and ‘increased speech’, ‘depressed mood’ and ‘worthlessness’ showed the highest mean scores and endorsement rates. BDRS score of the depressed group was significantly higher compared with the euthymic group. Three factors (i.e., psychosomatic, mood, and mixed) were identified in the principal component analysis and hierarchical cluster analysis of the BDRS.ConclusionIn this study, we report that the Korean version of BDRS is a feasible and reliable tool for the assessment of depression in adolescents with Early-onset bipolar disorders.

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Background: Atrial Fibrillation (AF) is the leading cause of embolic stroke and is associated with a 5-fold increased risk of stroke. Currently, less than 50% of high-risk patients are receiving a prescription for oral anticoagulants (OACs). Guidelines for Primary Prevention of Stroke recommend the emergency department (ED) as an important location for physicians to identify patients with AF and start them on OACs. Methods: A retrospective review was completed of AF patients in the ED from 2014-2018 at a large health system. The prevalence of OAC prescription was identified in three different cohorts: 1) patients discharged from the ED, 2) those admitted under observation status and discharged within 48 hours, and 3) those admitted to inpatient. CHA 2 D 2 -VASc scores were calculated and risk factors were reviewed. Results: We identified 438 patients: 106 in the ED cohort, 132 in the observation cohort and 200 in the inpatient cohort. The average age was 63.1. 77.9% had hypertension and 46.35% were women. The average CHA 2 D 2 -VASc score was 2.45 in the ED cohort, 2.56 in the observation cohort and 3.35 in the inpatient cohort. ED physicians addressed AF in 77% of the ED cohort. Out of the high-risk patients (CHA 2 D 2 -VASc score ≥ 2) discharged from the ED, 17% were newly prescribed an OAC compared to 74% of patients who were admitted under observation status and 78% of patients admitted to inpatient. (7/40 [17.5%] vs 39/53 [73.6%]; p<.0001 and 83/107 [77.6%]; p<.0001) Direct OACs were more commonly prescribed over Warfarin across all three groups. (92.3% in ED, 88.5% in observation, 82.5% in inpatient). Conclusions: Patients with AF are more likely to be prescribed an OAC if admitted to inpatient or under observation status compared to the ED. There were many missed opportunities in the ED to start patients on OACs. Further studies should identify barriers to OAC prescription in the ED to implement better practice strategies.

Objective This study aimed to examine personality profiles and behavioral problems of children with nail biting (NB) to gain insight into the developmental trajectory of pathological NB.Methods 681 elementary school students were divided into non NB (n=436), occasional NB (n=173) and frequent NB group (n=72) depending on the frequency of NB reported in Child Behavioral Checklist (CBCL). Children’s personality was assessed using the Junior Temperament and Character Inventory (JTCI), and behavioral problems were assessed using the CBCL. Latent Profile Analysis (LPA) was performed using JTCI profiles to classify personalities of the children with NB (belonging to frequent and occasional NB group, n=245).Results For subscale scores of CBCL, the total, internalizing, externalizing, anxious/depressed withdrawn/depressed, depression, thought, rule-breaking, and aggressive behavior problems, were most severe in the frequent NB group followed by occasional NB and non NB group. LPA of personality profile in children with NB revealed four classes (‘adaptiveness,’ ‘high reward dependence,’ ‘low self-directedness,’ and ‘maldaptiveness’). The four personality classes demonstrated significant group differences in all of the CBCL subscales. Children who showed low self-directedness and cooperativeness and high novelty seeking and harm avoidance personality profiles demonstrated highest tendency for problematic behavior irrespective of the frequency of NB.Conclusion Children with NB reported significantly more problematic behaviors compared to children without NB. Children with specific personality profile demonstrated higher tendency for problematic behavior irrespective of the frequency of NB. Therefore, accompanying personality profiles should be considered when assessing behavioral problems in children with NB.