Yoo Hyun Um

Song J, et al. J Korean Med Sci. 2027 Mar;42:e64. https://doi.org/10.3346/jkms.2027.42.e64

Baek JH, et al. J Korean Med Sci. 2027 Mar;42:e55. https://doi.org/10.3346/jkms.2027.42.e55

Objective Narcolepsy often begins in adolescence, yet diagnosis is frequently delayed. This study aimed to identify factors associated with delayed diagnosis of narcolepsy, defined as more than 1 year between symptom onset and diagnosis, focusing on age at onset, clinical symptoms, and family history.Methods We recruited 235 patients with clinically diagnosed narcolepsy from St.Vincent’s Hospital in South Korea. Participants completed an online survey assessing age at symptom onset, diagnostic timing, clinical features, and family history of sleep disorders. Patients were classified into a non-delay group (diagnosis within 1 year, n=53) and a delay group (diagnosis after 1 year, n=182). Group differences were analyzed using independent t-tests and chi-square tests.Results The mean diagnostic delay was 0.49±0.50 years in the non-delay group and 10.96±8.37 years in the delay group. The delay group had a significantly younger age at symptom onset than the non-delay group (15.13±4.88 vs. 17.89±7.91 years, p=0.002). Diagnosis in the delay group typically occurred only after marked functional impairment due to excessive daytime sleepiness. Cataplexy showed a nonsignificant trend toward earlier diagnosis, while other narcolepsy symptoms and family history were not associated with diagnostic timing.Conclusion Earlier age at onset is the strongest risk factor for delayed diagnosis of narcolepsy. Neither symptom profile nor family history reliably facilitates early recognition. Proactive screening and improved awareness among clinicians and families are needed to reduce diagnostic delay and its psychosocial burden.

Kang Yoon Jung, Jong-Hyun Jeong, Hyejin Tae, Yoo Hyun Um, Jae Hyun Yoo. Clin Psychopharmacol Neurosci -0001;0:. https://doi.org/10.9758/cpn.26.1468

Objective Cardiovascular health (CVH), assessed through Life’s Essential 8 (LE8), has been widely studied in relation to physical health outcomes. However, its association with mental health, including psychological distress, suicidal behavior, and mental health service utilization, remains underexplored. This study examined whether better CVH is associated with reduced risk of mental health problems and greater engagement with mental health services.Methods We conducted a cross-sectional analysis using data from 4,106 Korean adults aged ≥19 years from the 2021 Korea National Health and Nutrition Examination Survey. CVH was measured using LE8 and categorized into low (0–49), moderate (50–79), and high (80–100) groups. Mental health outcomes included perceived stress, depressive mood, suicidal ideation, suicide planning, suicide attempts, and mental health service utilization.Results Higher LE8 scores were significantly associated with lower stress (p=0.041) and reduced odds of suicidal ideation (p=0.001). Compared to the low CVH group, adjusted odds ratios (ORs) for stress perception were 0.748 (95% confidence interval [CI]: 0.587–0.953) in the moderate group and 0.685 (95% CI: 0.491–0.956) in the high group. For suicidal ideation, the ORs were 0.517 (95% CI: 0.329–0.813) and 0.199 (95% CI: 0.078–0.507), respectively. LE8 health behaviors, not health factors, were significantly associated with stress perception and suicidal ideation.Conclusion Better CVH is associated with lower psychological distress and suicidal behavior, with health behaviors in LE8 showing stronger associations with mental health outcomes than health factors. Further longitudinal studies are needed to confirm causality and underlying mechanisms.

Background and Objective Depression and attentional difficulties are prevalent in narcolepsy. Although depression has been noted in first-degree relatives, the impact of sleep disturbances on these self-reported symptoms remains unclear. We investigated depressive symptoms and attention-deficit/hyperactivity disorder (ADHD)-related traits in patients and their relatives, while controlling for sleep quality and sleepiness.Methods A cross-sectional study included 613 participants: narcolepsy patients (n=253), first-degree relatives (n=156), and healthy controls (n=204). We measured symptoms using the Beck Depression Inventory-II (BDI-II), Adult ADHD Self-Report Scale (ASRS), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). We analyzed group differences using ANCOVA, adjusting for age, sex, body mass index, PSQI, and ESS.Results Patients exhibited significantly high unadjusted scores for depression (mean, 27.51) and attentional symptoms (mean, 11.47). After controlling for covariates, group status remained significantly associated with BDI-II total scores (F=25.03, p<0.001), with both patients and relatives reporting higher levels of depression than controls. Notably, affective-cognitive items on the BDI-II remained elevated. However, the group effect on the ASRS was no longer significant after adjustment (F=1.45, p=0.236).Conclusions Depressive symptoms were consistently elevated in both patients and first-degree relatives, even after accounting for sleep quality and daytime sleepiness, indicating a potential shared familial vulnerability. In contrast, ADHD-like symptoms appeared to be largely influenced by sleep quality and excessive daytime sleepiness, indicating they may be state-dependent.

Suhyung Kim, Young-chan Kim, Yoo Hyun Um, Tae-Won Kim, Ho-Jun Seo, Seung-Chul Hong, Sung-Hoon Yoon, Jong-Hyun Jeong. Clin Psychopharmacol Neurosci -0001;0:. https://doi.org/10.9758/cpn.25.1378

Background: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by cognitive deficits predominantly linked to hippocampal and cortical atrophy. Emerging evidence highlights the cerebellum's involvement in both cognitive and neuropsychiatric symptoms of AD, challenging its traditional characterization as resistant to AD pathology. This study investigates longitudinal cerebellar volume changes across the AD spectrum, from preclinical stages to dementia, and their associations with cognitive and neuropsychiatric symptoms. Methods: A total of 229 older adults from the Catholic Aging Brain Imaging Database (CABID) were classified into four groups: Normal Cognition (NC), Preclinical AD (PAD), Aβ‐positive Mild Cognitive Impairment (MCI), and AD Dementia (ADD). Over an average follow‐up of two years, participants underwent MRI, PET imaging, and clinical assessments. Regional cerebellar volumes were analyzed using SPM12 with the SUIT atlas, and statistical models assessed group differences and longitudinal changes. Results: At baseline, significant cerebellar volume reductions were identified in the ADD group, particularly in Crus I, Crus II, and the Vermis. Longitudinal analyses revealed progressive volume reductions in the PAD group, notably in the left Crus I and left VI, preceding significant cognitive decline. In contrast, no longitudinal changes were observed in the NC or MCI groups. Notably, cerebellar volume reductions in the PAD group correlated with episodic memory performance, while reductions in the ADD group were linked to neuropsychiatric symptoms, including psychosis, irritability, and euphoria. These findings underscore the cerebellum's involvement in AD pathology and its interconnected role with cortical regions in executive function and memory. Conclusion: Longitudinal cerebellar volume changes offer critical insights into the trajectory of AD, suggesting that the cerebellum may serve as an early biomarker and potential therapeutic target in AD progression.

Objective The visual system plays a crucial role in regulating sleep by providing cues that synchronize the circadian rhythm. Consequently, ophthalmic diseases—particularly diabetic retinopathy (DMR), age-related macular degeneration (AMD), epiretinal membrane (EM), and glaucoma—may influence sleep duration through circadian disruption and disease-related psychological stress. However, large-scale studies examining the relationship between these conditions and sleep duration remain limited. This study investigated these associations in a nationwide, population-based sample.Methods This cross-sectional study analyzed data from the 2019 and 2020 the Korea National Health and Nutrition Examination Survey. Ophthalmic diseases were diagnosed through fundoscopy, and sleep duration on weekdays and weekends was self-reported. The study included 8,395 participants aged 40 years or older who underwent fundoscopy. Statistical models were adjusted for demographic and clinical covariates, including age, sex, body mass index, and comorbidities.Results Patients with DMR and EM had significantly reduced sleep duration, with reductions of 0.3 hours to 0.5 hours on weekdays and weekends compared to individuals without these conditions. No significant differences in sleep duration were observed for AMD or glaucoma. After covariate adjustment, the associations between shorter sleep duration and DMR or EM remained significant.Conclusion This nationwide population-based study using fundus photography revealed that DMR and EM are significantly associated with reduced sleep duration, while AMD and glaucoma are not. These findings suggest a differential sleep impact by disease type and support the need for targeted evaluation and management of sleep in patients with ophthalmic diseases. Further research is warranted to clarify underlying mechanisms and guide public health strategies.