Journal of Oriental Neuropsychiatry (동의신경정신과학회지)

The Korean Society of Oriental Neuropsychiatry (대한한방신경정신과학회)
권호 표지
DOI QR코드

DOI QR Code

Korean Medicine Treatments for Delirium in an Elderly Patient Caused by Sedative-Hypnotics Overdose

진정수면제를 음독한 노인 입원 환자에서 발생한 섬망에 대한 한의복합중재 증례보고

  • Han-byul Cho (Department of Oriental Neuropsychiatry, Graduate School of Oriental Medicine, Dongguk University) ;
  • Byung-Soo Koo (Department of Oriental Neuropsychiatry, Graduate School of Oriental Medicine, Dongguk University) ;
  • Geun-Woo Kim (Department of Oriental Neuropsychiatry, Graduate School of Oriental Medicine, Dongguk University)
  • 조한별 (동국대학교 한의과대학 한방신경정신과학교실) ;
  • 구병수 (동국대학교 한의과대학 한방신경정신과학교실) ;
  • 김근우 (동국대학교 한의과대학 한방신경정신과학교실)
  • Received : 2023.12.10
  • Accepted : 2023.12.25
  • Published : 2023.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: The purpose of this study was to report the effectiveness of the combination of Korean medicine therapy on elderly patients with delirium due to overdose of sedative-hypnotics. Methods: The patient was diagnosed with delirium, which occurred after an overdose of sedative-hypnotics. The patient received Korean Medicine treatment, including herbal medicine, acupuncture, moxibustion and psychotherapy, and other treatments. The evaluation variables to check the effectiveness of the interventions were the Korean Version of the Delirium Rating Scale-Revised-98 (K-DRS-R-98) Mini-Mental State Examination-Korean (MMSE-K) Clinical Dementia Rating (CDR) and Manual Muscle Test (MMT). Results: During the hospitalization period, the K-DRS-R-98 score decreased from 31 to 4, MMSE-K score increased from 18 to 26. CDR score decreased from 2 to 0. MMT in the Right lower extremity was improved. Normal daily activities were possible. Conclusions: Combining Korean Medicine treatments, including herbal medicine, acupuncture, moxibustion, psychotherapy, and other treatments, may help alleviate delirium.

Keywords

References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders Fifth Edition (DSM-5®). 5th ed. Washington. DC: American Psychiatric Association; 2013.
  2. Park JS, Kim JJ, Park SJ, Kim SM, Park JY. Clinical Course according to Antipsychotics Prescription Pattern in Delirium. Korean J Psychosom Med. 2017;25:120-8.
  3. CS Im, SM Cha, JH Kim, JM Lee, JL Kim. Retrospective Study on the Development and Outcome of Delirium in Elderly Inpatient. J Korean Soc Biol Ther Psychiatry. 2012;18:186-92.
  4. You SB, Lee JH. A Systematic Review of Non-pharmacological Interventions for Delirium Prevention in Elderly Inpatients. J Korean Acad Fundam Nurs. 2021;28:249-62. https://doi.org/10.7739/jkafn.2021.28.2.249
  5. Shin JY, Moon YS, Lee JM, Uhm KE, Jeong MY, Choi JK, Kim YS, Kim KJ. Clinical Practice Guideline for Screening of Delirium in Hospitalized Older Adults. Korean J Fam Pract. 2018;8:645-53. https://doi.org/10.21215/kjfp.2018.8.5.645
  6. Min SS, Kim YK, Kwon JN. Clinical Report on the Byun-jo Accompanied Delirium. The Journal of Korean Oriental Physiology and Pathology. 2005;19:1715-9.
  7. Seo MJ, Yuk SW. A Study on the Jeon Kwang Pyun of the Young Chu. Journal of Korean Medical classics. 1998;11:360-94.
  8. The Korean Society of Oriental Neuropsychiatry. Neuropsychiatry of Korean Medicine. Seoul: Maver Publishing. 2018:674-9,719-20.
  9. Ku BD, Hong JH. Clinical Approach to the Patients with Delirium in the Neurocritical Care. J Neurocrit Care. 2010;3:27-37.
  10. Lee J, Lee HJ, Kim SY, Kim JL. A Study for the Diagnosis, Severity and Subtypes of Delirium Using the Korean Version of Delirium Rating Scale-Revised-98 (K-DRS-98). J Korean Soc Biol Ther Psychiatry. 2008;14,2008.
  11. Folstein MF, Folstein SE, McHugh PR."Mini-Mental State". A practical method for grading the cognitive state patients for the clinician. J Psychiatr Res. 1975;12:189-98. https://doi.org/10.1016/0022-3956(75)90026-6
  12. Kwon Y, Park J. Standardization of Korean Version of the Mini-Mental State Examination(MMSE-K) in the Elderly. J Korean Neuropsychiatr Assoc. 1989;28:125-35.
  13. Park JH, Kwon YC. Standardization of Korean Version of Mini-Mental State Examination (MMSE-K) for use in the elderly. Part II. Diagnostic validity. J Korean Neuropsychiatr Assoc. 1989;28:508-13.
  14. Oh BH, Cha KR, Hong CH, Kim JH. Characteristics of behavioral and psychological symptoms by dementia stage: evaluated by the Korean version of neuropsychiatric inventory. J Korean Neuropsychiatr Assoc. 2004;43:596-602.
  15. Choi IS. Steps to internal medicine. 3rd ed. Seoul: Jeongdam Publishing. 2008;59-62.
  16. Trzepacz PT. The neuropathogenesis of delirium. A need to focus our research. Psychosomatics. 1994;35:374-91. https://doi.org/10.1016/S0033-3182(94)71759-X
  17. Jones RN, Kiely DK, Marcantonio ER. Prevalence of delirium on admission to postacute care is associated with a higher number of nursing home deficiencies. J Am Med Dir Assoc. 2010;11:253-6. https://doi.org/10.1016/j.jamda.2009.08.009
  18. Abraha I, Rimland JM, Trotta F, Pierini V, Cruz-Jentoft A, Soiza R, et al. Non-pharmacological interventions to prevent or treat delirium in older patients: clinical practice recommendations the SENATOR-ONTOP series. Journal of Nutrition, Health & Aging. 2016;20:927-36. https://doi.org/10.1007/s12603-016-0719-9
  19. Cho HN, Lee OS, Lim SC. Evaluation of Drug Use Causing Delirium and Drowsiness in Elderly Patients of Korea. Kor. J. Clin. Pharm. 2012;22:30-40.
  20. Kim SK, Lee SH. Drug-likeness and Oral bioavailability for Chemical Compounds of Medicinal Materials Constituting Oryeong-san. Kor. J Herbol. 2018;33:19-37.
  21. Kim BK, Jung SY, Jung KY. Characteristics of elderly patients with acute poisoning. J Korean Soc Clin Toxicol. 2010;8:61-8.
  22. Tombaugh TN. Test-retest reliable coefficients and 5-year change scores for the MMSE and 3MS. Arch Clin Neuropsychol. 2005;20:485-503. https://doi.org/10.1016/j.acn.2004.11.004
  23. Kim H, Kim JW, Kang HJ, Kim SY, Lee JY, Kim JM, Shin IS, Yoon JS, Kim SW. Factors Associated with Suicidal Behavior of Psychiatric Inpatients. J Korean Neuropsychiatr Assoc. 2019;58:202-8. https://doi.org/10.4306/jknpa.2019.58.3.202