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Objective: This study aimed (1) to identify distinct subgroups of psychiatric patients referred for a mental health certificate for military service suitability and (2) to determine whether there is a difference in clinical features such as treatment responsiveness and prognosis among certain subgroups. Methods: We conducted latent profile analysis (LPA) using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) clinical profiles of the participants. Linear mixed model analysis was performed to examine changes in the severity of clinical symptoms and functional level according to the treatment period of the latent classes derived from the LPA. Results: The results indicated that the best-fitting model was a three-class model, comprising Class 1 (mild maladjustment), Class 2 (neurotic depression and anxiety), and Class 3 (highly vulnerable and hypervigilant). We demonstrated that the three subgroups displayed different characteristics in treatment responsiveness and clinical course based on their Clinical Global Impression-Severity and Global Assessment of Functioning scores over a treatment period of 6 months. While subjects in Classes 1 and 2 significantly improved over 6 months, those in Class 3 showed little or no improvement in our clinical parameters. Conclusion: This study has yielded data with clinical implications for treatment planning and interventions for each subgroup classified that were based on MMPI-2 clinical profiles of military recruits who might be maladjusted to serve. [ABSTRACT FROM AUTHOR]

Objective: Effective suicide prevention for at-risk adolescents requires increased access to medical treatment. Investigating the unique characteristics of suicide in this vulnerable at-risk non-referred sample can contribute to establishing effective suicide prevention policies. This study aimed to (a) examine at-risk non-referred adolescents' suicide attempt rate, (b) investigate influential multilevel factors in predicting these adolescents' suicide attempts, and (c) compare the results of (a) and (b) by gender. Methods: A total of 401 samples (216 boys and 185 girls) were recruited through a school-based mental health project for at-risk adolescents. Multivariate hierarchical logistic regression analyses were performed at the individual-, contextual-, and protective levels to evaluate three multilevel models as well as to investigate predictabilities for the overall group and by gender. Results: The suicide attempt rate of the overall sample was 29.4% (boys: 18.1%, girls: 42.7%), which was significantly higher than that of community samples. For boys, individual-level predictors (depression and conduct problems) had the most significant contribution in predicting suicide attempts. In contrast, for girls, protective-level predictors (family satisfaction) contributed the most to the prediction of suicide attempts, followed by contextual-level predictors (academic grades). Conclusion: This study is an important step in understanding the unique characteristics of at-risk non-referred adolescents who have not yet been considered in mental health policies. Improving medical accessibility will be the first step in establishing effective suicide prevention policies for these vulnerable samples. [ABSTRACT FROM AUTHOR]

Objective: Whether long-acting injectable antipsychotics (LAI) are superior to oral antipsychotics remains a controversial question, and results vary depending on the study design. Our study was performed to compare outcomes of oral antipsychotics and paliperidone palmitate (PP) in clinical practice by investigating the numbers of admissions and bed days. Methods: We performed a retrospective observational mirror-image study at a single medical center, reviewing medical charts to obtain the clinical data. Forty-six patients with a diagnosis of schizophrenia or schizoaffective disorder who had received at least two doses of PP were included in the analysis. The Wilcoxon signed-rank test was used to compare the numbers of bed days and admissions 1 year before starting PP with those numbers at 1 year after. Results: The mean number of admissions fell from 0.83 to 0.17 per patient ( p < 0.0002), and the median fell from 1 to 0. The mean number of bed days decreased significantly, from 24.85 to 8.74 days ( p < 0.006). The outcomes remained similar in sensitivity analyses set up with different mirror points. Conclusion: Our results indicate that initiating PP reduced the mean numbers of hospital admissions and bed days compared with prior oral medication. LAIs may thus be cost effective in practice; its use bringing about cost reductions greater than its purchase cost. [ABSTRACT FROM AUTHOR]

We examined predictors of suicide attempts in clinically depressed adolescents in Korea and gender differences in suicidal behavior. In total, 106 adolescents diagnosed with depressive disorder were recruited in South Korea. We assessed various variables that might affect suicide attempts, and used a structured interview for the diagnosis of depression and comorbidities and to evaluate suicidality. Demographic and clinical characteristics of the subjects were compared between suicide attempt and non-suicide attempt groups and we examined significant predictors of suicide attempts. Gender differences in suicidal ideation and suicidal behavior were also analyzed. Among 106 depressed participants, 50 (47.2%) adolescents were classified in the suicide attempt group. Generally, the suicide attempt and non-suicide attempt group shared similar clinical characteristics. The suicide attempt group had more females, more major depressive disorder diagnoses, more depressive episodes, and higher suicidal ideation than the non-suicide attempt group. Suicidal ideation was the only significant predictor of suicidal attempt, regardless of gender. Higher suicidal ideation frequency scores and more non-suicidal self-injurious behaviors were shown in the female suicide attempt group than the male suicide attempt group. It is recommended that suicidal ideation be assessed regularly and managed rigorously to decrease suicide risks in depressive adolescents. [ABSTRACT FROM AUTHOR]