Schizophrenia In South Korea Research Articles

The Mediating Role of Positive Thinking on the Relationship Between Depression and Functional Recovery in Community-Dwelling People With Schizophrenia.

Functional recovery as a consumer-centered approach is critical to recovery for community-dwelling people with schizophrenia. The current study investigated the mediating role of positive thinking in the relationship between depression and functional recovery in community-dwelling people with schizophrenia in South Korea. Depression, positive thinking, and functional recovery measures were completed by 158 people with schizophrenia in the community with self-reported questionnaires. Depression had a significantly negative influence on functional recovery. Positive thinking fully mediated the relationship between depression and functional recovery. An effective intervention strategy for functional recovery in this population may reinforce positive thinking and depression management. [Journal of Psychosocial Nursing and Mental Health Services, 61(2), 44-52.].

Lack of continuity of care experienced by people diagnosed with schizophrenia in South Korea.

People diagnosed with schizophrenia (PDS) will find seamlessly coordinated services and care in their communities if they are delivered with a high level of continuity of care (COC). Most studies of COC were conducted in Western countries that initiated deinstitutionalisation several decades ago. Limited studies highlight experiences of COC among PDS who live in societies still heavily relying on institutionalised care, such as prolonged hospitalisation, like South Korea where PDS stay in psychiatric hospitals over 100days on average. This qualitative study explored COC that PDS experienced in South Korea. We focused on cross-boundary COC, which refers to service coordination at a given moment, and longitudinal COC, which refers to care over a period of time. Twenty-one PDS completed in-depth interviews from June to August 2017. Fifteen participants were male (71.4%), and ages ranged from 26 to 71. We used grounded theory techniques for data analysis, including initial open coding, in vivo coding, constant comparison and axial coding. Findings include that PDS experienced poor longitudinal COC when discharge planning during hospitalisation was absent, which undermined their ability to live independently. Poor employment support effectively undermined recovery even if PDS worked hard to attain economic self-sufficiency. As for cross-boundary COC, poor communication between psychiatrists and providers offering psychiatric rehabilitation services was a barrier. PDS in general had difficulties locating needed psychiatric rehabilitation services in the community. The lack of COC appeared to arise from particular sociocultural contexts, including poor self-determination in consumer-provider relationships, families' lack of knowledge and support, and discrimination and prejudice. Despite experiences with discrimination, no participants appeared to have internalised messages that they are 'less than' those without mental illnesses. Findings highlight the significance of multi-pronged approaches to increase COC, which can effectively link PDS, families, psychiatrists and psychiatric rehabilitation service providers.

Effectiveness of antipsychotic drugs in schizophrenia: a 10-year retrospective study in a Korean tertiary hospital

Extensive research has been carried out on the comparative effectiveness of antipsychotic medications. Most studies, however, have been performed in Western countries. The purpose of this study was to compare the effectiveness, indicated by time to any-cause discontinuation, of antipsychotic drugs in a large number of patients with schizophrenia in South Korea. We identified 1458 patients with schizophrenia or schizophreniform disorder who were treated with antipsychotic medications using a clinical data warehouse at the Seoul National University Hospital between March 2005 and February 2014. Kaplan–Meier survival analyses were used to estimate the time to discontinuation of antipsychotic drugs. We compared the survival curves of different antipsychotics using log-rank tests. Overall, the median time to discontinuation for any cause was 133 days (95% CI, 126–147). The longest time to discontinuation was observed for clozapine, followed by aripiprazole, paliperidone, olanzapine, amisulpride, risperidone, quetiapine, ziprasidone, and haloperidol. Specifically, clozapine was significantly different from all other antipsychotic drugs (all p < 0.001). Aripiprazole also had a significantly longer time to discontinuation than amisulpride (p = 0.001), risperidone (p < 0.001), quetiapine (p < 0.001), ziprasidone (p < 0.001), and haloperidol (p < 0.001). In Asian patients with schizophrenia, clozapine was the most effective antipsychotic in terms of time to discontinuation, followed by aripiprazole. This study extends the findings of previous effectiveness studies from Western populations and suggests the need to develop guidelines for the pharmacotherapy of schizophrenia tailored to Asian individuals.

The cost-of-illness trend of schizophrenia in South Korea from 2006 to 2016.

Globally, about one in four people develop a psychiatric disorder during their lifetime. Specifically, the lifetime prevalence of schizophrenia is about 0.48%, and schizophrenia can have detrimental effects on a patient's life. Therefore, estimating the economic burden of schizophrenia is important. We investigated the cost-of-illness trend of schizophrenia in South Korea from 2006 to 2016. The cost-of-illness trend was estimated from a societal perspective using a prevalence-based approach for direct costs and a human capital approach for indirect costs. We utilized information from the following sources: 1) National Health Insurance Service, 2) Korean Statistical Information Service, Statistics Korea, 3) the National Survey of Persons with Disabilities, 4) Budget and Fund Operation Plan, Ministry of Justice, 5) Budget and Fund Operation Plan, Ministry of Health and Welfare, and 6) annual reports from the National Mental Health Welfare Commission. Direct healthcare costs, direct non-healthcare costs, and indirect costs by sex and age group were calculated along with sensitivity analyses of the estimates. The cost-of-illness of schizophrenia in Korea steadily increased from 2006 to 2016, with most costs being indirect costs. Individuals in their 40s and 50s accounted for most of the direct and indirect costs. Among indirect costs, the costs due to unemployment were most prevalent. Our estimation implies that schizophrenia is associated with a vast cost-of-illness in Korea. Policymakers, researchers, and physicians need to put effort into shortening the duration of untreated psychosis, guide patients to receive community-care-based services rather than hospital-based services and empower lay people to learn about schizophrenia.

Comparative Study of Clinical Features between Early- and Late-Onset Schizophrenia in South Korea

Comparative Study of Clinical Features between Early- and Late-Onset Schizophrenia in South Korea

Effects of a mental fitness positive psychology intervention program on inpatients with schizophrenia in South Korea: A feasibility study

This study investigated the effects of a mental fitness positive psychology intervention program on the self-esteem and interpersonal relationship ability of inpatients with schizophrenia. A pretest-posttest nonequivalent control group quasi-experimental design was used. Participants (N = 60) completed scales measuring self-esteem and interpersonal relationship ability. The program effectively improved participants' self-esteem and interpersonal relationship ability. Psychiatric nurses can use this program as a nursing intervention to enhance the self-esteem and interpersonal skills of inpatients with schizophrenia in mental health facilities.

Changes in antipsychotic drug usage and factors affecting the use of typical drugs based on nationwide health insurance data in South Korea

ObjectivesTo determine changes in antipsychotic drug usage in all South Korean patients with schizophrenia in 2011–2015 and factors affecting their utilisation in 2015.Design and settingRetrospective cohort study using health insurance...

Lay beliefs about the causes and cures of schizophrenia.

Lay beliefs about schizophrenia are an important factor associated with treatment-seeking behavior. This study was conducted to investigate the lay beliefs about the causes and treatments of schizophrenia in South Korea. A total of 654 adults (mean age, 35.96 ± 11.33 years) completed two questionnaires assessing their views on the causes and cures of schizophrenia. The factor structures of lay beliefs about the causes and treatments of schizophrenia were then analyzed and the correlations between the resultant factors investigated. From the cause items, four factors were extracted: Health/Lifestyle, God/Fate, Social/Environmental and Biological. Four factors were also extracted from the treatment items: Self-Help/Stress Management, Physical Treatment/Health Management, Religious Help and Mental Health Service Utilization. Notably, most participants believed that items in the Social/Environmental and Biological factors were the causes of schizophrenia, while they believed that items in the Mental Health Service Utilization and Self-Help/Stress Management factors were the treatments. Participants' beliefs about the causes and treatments of schizophrenia were systematically correlated. Overall, laypeople have reasonably accurate beliefs and a multidimensional view of the causes and treatments of schizophrenia. Nevertheless, our results suggest that public education about the etiology and treatment of schizophrenia are necessary to increase actual usage of mental health services and treatments for schizophrenia.

Effectiveness of Shared Decision-Making Training Program in People With Schizophrenia in South Korea

This study aimed to investigate the effects of shared decision-making (SDM) training program on self-esteem, problem-solving ability, and quality of life in people with schizophrenia. A quasi-experiment with a nonequivalent control group pre-posttest design was conducted. The self-esteem scale, the problem-solving ability scale, and the WHOQOL Scale were used. The SDM training program was effective in improving their self-esteem, problem-solving ability, and quality of life in people with schizophrenia. The SDM training program can be used in various mental health fields such as hospitals, mental health centers, and rehabilitation facilities.

Developing a Prediction Model for Quality of Life in Patients with Schizophrenia

Purpose: In this study an exploration was done of the quality of lives of patients with schizophrenia in South Korea and factors related to quality of life, and to develop a model that predicts the quality of their lives. Methods: The participants were 225 patients with schizophrenia, aged 18 and above, residing in Seoul and Gyeonggi-Province. Collected data was analyzed using SAS 9.3 and AMOS 18.0. Results: Social support and psychological well-being were the two factors that most affected the quality of life in patients with schizophrenia. Symptoms, empowerment, and internalized stigma were not found to influence the quality of the patients' lives. However, symptoms, social support, empowerment, internalized stigma affected the patients' psychological well-being, and psychological well-being was identified as an influential variable for quality of life in patients with schizophrenia. Therefore, symptoms, social support, empowerment, and internalized stigma are influential to the patients' quality of lives through psychological well-being. Conclusion: These results suggest that the quality of life in patients with schizophrenia should be examined through the variable of psychological well-being as many variables related to the patients' quality of life affect psychological well-being.

Cost-Effectiveness of Sertindole among Atypical Antipsychotics in the Treatment of Schizophrenia in South Korea

ObjectivesThis study assessed the cost-effectiveness of sertindole compared with existing atypical antipsychotics in the treatment of patients with schizophrenia in the South Korean setting. MethodsA Markov model was developed to estimate the cost-effectiveness of sertindole compared with risperidone, olanzapine, and quetiapine with a cycle of 6 months on a 5-year time horizon. Effectiveness was defined as the length of time without relapse and quality-adjusted life-years. Parameter estimates including drug-induced adverse events, compliance rate, and relapse rate were based on published literature and clinical trial data. Resource utilization data were obtained from the 2010 National Health Insurance reimbursement data, and costs were estimated from the health care system's perspective. A discount rate of 5% was applied to both cost and effectiveness. One-way sensitivity analyses and probabilistic sensitivity analysis were carried out to check the robustness of the base-case analysis. ResultsThe length of time without relapse was 1.90 years for all study drugs. The estimated quality-adjusted life-years were 1.27 for sertindole, followed by quetiapine, risperidone, and olanzapine. Total costs were 10.51 million Korean won (KRW) for sertindole, 12.86 million KRW for olanzapine, 8.38 million KRW for risperidone, and 8.91 million KRW for quetiapine. The incremental cost-effectiveness ratios showed that sertindole was dominant only over olanzapine and was not cost-effective compared with risperidone and quetiapine. Various sensitivity analyses confirmed the results from the base-case analysis. ConclusionsSertindole may be considered a valuable treatment option for South Korean patients who have failed the therapy with other atypical antipsychotic agents.

Factors associated with long-stay status in patients with schizophrenia: An analysis of national databases covering the entire Korean population

Admissions lasting over six months (long-stay) occur frequently among patients with schizophrenia in South Korea. To identify some patient-level and institution-level factors associated with long-stay status of patients with schizophrenia. This is a retrospective cross-sectional study. We analysed a nationwide population-based reimbursement claims data set consisting of 496,338 claims for 58,287 patients with schizophrenia between 1 January 2005 and 30 June 2006. A two-level random effects logistic regression model was used to identify those factors. Age (<20 years (ref), 60-69 (OR 2.000, 95% CI: 1.640-2.438), ≥ 70 (2.068, 1.682-2.543)), male gender (1.192, 1.144-1.242), type of national health insurance plan (national health insurance (ref), Medical Care Aid Type 1 (4.299, 4.024-4.593)), secondary diagnosis (none (ref), psychiatric diagnosis (0.719, 0.666-0.777), non-psychiatric diagnosis (0.918, 0.850-0.991)) and type of institution (clinic (ref), psychiatric hospital (2.769, 1.507-5.087)) were associated with likelihood of long-stay status. Institutional variable associated with long-stay status included a higher number of beds (1.073, 1.013-1.137). The number of professionals (0.752, 0.646-0.876) showed negative association with long-stay status. Researchers could improve their assessment of long-stay status of patients with schizophrenia by using a two-level analysis including patient-level and institution-level factors. This study suggests that mental health interventions to reduce the long stay of patients with schizophrenia focus on older male patients, those enrolled in a national medical care aid programme and those admitted to psychiatric hospitals.

Relationships between Cigarette Smoking and Socio-Demographic and Clinical Characteristics in Patients with Schizophrenia in South Korea

Da-Ham Cho, MD, Kyoung-Sae Na, MD, PhD, Yong-Sik Kim, MD, PhD, Jin-Sang Yoon, MD, PhD, Yong-Min Ahn, MD, PhD, Jong-Il Lee, MD, PhD, Jin-Hee Han, MD, PhD, Jong-Woo Kim, MD, PhD, Seong-Gon Ryu, MD, PhD, Kyung-Joon Min, MD, PhD, Ki-Chang Park, MD, PhD and Chul-Eung Kim, MD, PhD Department of Psychiatry, Inha University School of Medicine, Inha University Hospital, Incheon, Korea Department of Psychiatry, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea Department of Psychiatry, Dongguk University College of Medicine, Ilsan Hospital, Goyang, Korea Department of Psychiatry, Chonnam National University College of Medicine, Chonnam National University Hospital, Gwangju, Korea Department of Psychiatry, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea Department of Psychiatry, Seoul National Hospital, Seoul, Korea Department of Psychiatry, The Catholic University of Korea College of Medicine, St. Vincent’s Hospital, Suwon, Korea Department of Psychiatry, Kyunghee University School of Medicine, Kyunghee University Medical Center, Seoul, Korea Department of Psychiatry, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea Department of Psychiatry, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju Christian Hospital, Wonju, Korea

Economic burden of schizophrenia in South Korea.

This study estimates the treated prevalence of schizophrenia and the annual costs associated with the illness in Korea in 2005, from a societal perspective. Annual direct healthcare costs associated with schizophrenia were estimated from National Health Insurance and Medical Aid records. Annual direct non-healthcare costs were estimated for incarceration, transport, community mental health centers, and institutions related to schizophrenia. Annual indirect costs were estimated for the following components of productivity loss due to illness: unemployment, reduced productivity, premature mortality, and caregivers' productivity loss using a human capital approach based on market wages. All costs were adjusted to 2005 levels using the healthcare component of the Consumer Price Index. The treated prevalence of schizophrenia in 2005 was 0.4% of the Korean population. The overall cost of schizophrenia was estimated to be $ 3,174.8 million (3,251.0 billion Won), which included a direct healthcare cost of $ 418.7 million (428.6 billion Won). Total direct non-healthcare costs were estimated to be $ 121 million (123.9 billion Won), and total indirect costs were estimated at $ 2,635.1 million (2,698.3 billion Won). Unemployment was identified as the largest component of overall cost. These findings demonstrate that schizophrenia is not rare, and that represents a substantial economic burden.

Sexual and physical abuse among Korean female inpatients with schizophrenia

The study reports the prevalence and correlates of sexual and physical abuse in a sample of 100 female inpatients with schizophrenia in South Korea. Clinical assessment interviews consisted of the Positive and Negative Syndrome Scale, the Scale for the Assessment of Positive Symptoms, an interview assessing history of sexual and repeated physical abuse, and demographic and psychosocial factors. Lifetime prevalence of severe sexual or physical abuse was 52%. Compared with nonabused patients (n = 48), the abused patients (n = 52) showed more nonpsychotic symptoms (i.e., anxiety, depression) and higher levels of distress, but no difference in psychotic symptoms. This study failed to note significant differences in positive symptoms addressed in previous Western studies.