• Title/Summary/Keyword: 만성정신질환

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A Preliminary Study on Depressive Symptoms and Glycemic Controls in Diabetic Patients (당뇨병 환자에서의 우울 및 관련증상에 관한 예비적 연구)

  • Ko, Seung-Hyun;Jeong, Jong-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Seung-Pil;Ahn, Yoo-Bae;Song, Ki-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.2
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    • pp.165-173
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    • 2004
  • Objectives: Diabetes mellitus is a heterogeneous, chronic, progressive disease characterized by hyperglycemia and abnormality in protein, carbohydrate, fat metabolism. Recent studies have reorted two times prevalence of depression in individuals with diabetes compared to individuals without diabetics. This study was designed to investigate glycemic controls, anxiety, alexithymia, stress responses between depressed diabetic patients and non-depressed diabetic patients. Methods The subjects were 60 diabetic patients(mean age : $50.3{\pm}9.7$ years, 31 men and 29 women) who were confirmed to have diabetes depending on the laboratory findings as welt as clinical symptoms at the St. Vincent Hospital Diabetes Clinic, from Mar. 2004 to Sep. 2004. Laboratory test including, blood chemistry. glycated hemoglobin, urinalysis for proteinuria and Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Based on BDI scores, all diabetics were divided into 13 depressed-diabetics group(above 20 point) and 47 non-depressed group(below 20 point). We compared demographic data. glycemic controls, STAI, TAS and SRI scores between two groups by independent t-test. Results : 1) Depressed diabetic groups were 13(mean age : $55.4{\pm}7.2$ years, 7 men and 6 women) and non depressed groups were 47(mean age $48.9{\pm}9.8$ years, 24 men and 23 women). In depressed diabetics, compared with non-depressed group, manifested aged(p=0.031), but other demographic data showed no difference between two groups. 2) No significant differences were noted in FBS, PP2h, Hb A1C, total cholesterol, HDL-cholesterol, SGOT/SGPT, BUN levels between depressed and non-depressed groups. But, blood creatine levels of depressed group were significantly increased than non-depressed group(p=0.026). 3) No significant differences were found in the score of STAI, STAI-S, STAI-T, TAS between depressed and non-depressed groups. 4) The SRI scores of depressed groups were significantly higher than non-depressed groups$(59.7{\pm}24.9\;vs.\;31.5{\pm}22.0)(p=0.000)$. Conclusion : The above results suggest that depressed diabetic patients are have more stress responses and higher blood creatine levels. However, there were no differences in laboratory data related to glycemic controls, and anxiety. alexithymia levels between two groups. We suggest that physicians should consider integrated approaches for psychiatric problems in the management of diabetes.

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Narcolepsy Variant Presented with Difficult Waking (각성장애로 발현한 기면증의 변종)

  • Lee, Hyang-Woon;Hong, Seung-Bong
    • Sleep Medicine and Psychophysiology
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    • v.7 no.2
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    • pp.115-119
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    • 2000
  • Objectives Summary: A 20-year-old man was presented with a history of difficult waking for 10 years. He suffered from morning headache, chronic fatigue and mild daytime sleepiness but had no history of irresistible sleep attack, cataplexy, hypnagogic hallucination or sleep paralysis. Methods: Night polysomnography (PSG), multiple sleep latency test (MSLT) and HLA-typing were carried out. Results: The PSG showed short sleep latency (4.0 min) and REM latency (2.5 min), increased arousal index (15.7/hour), periodic limb movements during sleep (PLMS index=8.1/hr) with movement arousal index 2.1/hr and normal sleep efficiency (97.5%). The MSLT revealed normal sleep latency (15 min 21 sec) and 4 times sleep-onset REM (SOREM). HLA-typing showed DQ6- positive, that corresponded at the genomic level to the subregion DQB1*0601, which was different from the usual locus in narcolepsy patients (DQB1*0602 and DQA1*0102). Conclusion: Differential diagnosis should be made with circadian rhythm disorder and other causes of primary waking disorder. The possibility of a variant type of narcolepsy could be suggested with an unusual clinical manifestation and a new genetic marker.

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Difference in Health-related Quality of Life between Medical Aid Beneficiaries and Health Insurance Beneficiaries using the Community Health Survey (지역사회건강조사를 이용한 의료급여수급권자와 건강보험가입자의 건강관련 삶의 질 비교 연구)

  • Hong, Ju-youn;Kim, Gha-jung
    • The Journal of the Korea Contents Association
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    • v.16 no.5
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    • pp.477-487
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    • 2016
  • This study attempts to comprehensively evaluate differences in sociodemographic characteristics, health behavior, disease morbidity, medical care and health-related quality of life of medical aid beneficiaries and health insurance beneficiaries. To achieve this, this study analyzes primitive data of community health survey that each health center had recently conducted in 2013. Study socioeconomic characteristics, health behavior, disease morbidity, medical care showed that various factors affecting health-related quality of life. It was found that medical aid beneficiaries showed lower health related-quality of life than health insurance beneficiaries because not good socioeconomic characteristics, health behavior, disease morbidity, and medical care and even as a comparative result after controlling socioeconomic characteristics, it was found that medical aid beneficiaries health-related quality of life was lower because of not good health behavior, disease morbidity, and medical care. Therefore, to improve health-related quality of life in medical aid beneficiaries as effectively as possible, improving mental health including managing chronic disease and stress and depression and daily living activities is above all important and our national concern with developing systematic program and policies focusing on health promotion behaviors such as moderate drinking habits and regular exercise and eating habits is required.

Health Management Experiences of Adolescents with Severe Congenital Heart Disease (중증 선천성 심장병 청소년의 건강관리 경험)

  • Hwang, Ji-Hye;Chae, Sun-Mi
    • The Journal of the Korea Contents Association
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    • v.20 no.9
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    • pp.659-671
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    • 2020
  • Severe congenital heart disease (CHD) is a chronic disease requiring continuous and holistic health management to improve patients' quality of life. This study explored the health management experiences of adolescents with severe CHDs in Korea. On the basis of in-depth interviews with nine youths, four categories and 12 subcategories were identified. The participants lacked a full understanding of their health status and the need for appropriate health management for their health status. Nonetheless, they practiced health management to some extent, in ways that were affected by heart function, self-identity, and social support. Although adolescents with severe CHDs were affected by physical limitations and the discriminatory gaze around them, they tried to achieve normalcy through managing information, seeking homogeneity with peers, and fostering positive acceptance about their disease. Regarding demands for health management programs, disease knowledge and mental health content were preferred, and the preferred delivery methods were self-help group camps and smartphone applications. Based on the results of this study, we suggest a health management intervention to promote a healthy transition to adulthood for adolescents with severe CHDs, and that policy-makers should consider measures that would enable a successful transition to adulthood in the future of youth with severe CHDs.

Assessment of Depression and Relates in Rural Elderly (농촌지역 노인의 우울수준과 관련요인)

  • Sohn, Seok-Joon;Shin, Jun-Ho;Shin, Hee-Young;Chung, Eun-Kyung;Bum, Min-Sun;Kweon, Sun-Seog
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.85-98
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    • 2000
  • The questionnaire survey using the Center for Epidemiological Studies-Depression Scale(CES-D) was conducted to determine the prevalence of depression and related factors in the rural elderly. The subjects were 922 individuals of 60 years of age and over, living in Chonnam province. The results of this study were as follows. The prevalence rates of depression were 14.6% in male and 24.4%, in female. As the age increased, the prevalence rate increased and the rate was higher in non-educational and widowhood group. The prevalence rate was lower in the group of having good health habits and having a good health status. In the regression analysis, significant predictors of the depression were sex, education, physical activity, perceived health status and body image. In conclusion, main, characteristics which had close relationship to depression in the rural elderly were physical function and self-rated health status.

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The Factors Influencing Health-Related Quality of Life in the Elderly - Focused on the General Characteristics, Health Habits, Mental Health, Chronic Diseases, and Nutrient Intake Status: Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2012 (우리나라 노인의 건강관련 삶의 질에 영향을 주는 요인 - 일반 특성, 생활습관, 정신건강, 만성질환, 영양섭취상태를 중심으로: 제5기 국민건강영양조사자료, 2010~2012)

  • Lee, Hye-Sang
    • Korean Journal of Community Nutrition
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    • v.19 no.5
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    • pp.479-489
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    • 2014
  • Objectives: This study intended to determine significant factors that influence the health-related quality of life ("HRQoL"; EuroQol 5 Dimension health-related quality of life (EQ_5D) & EuroQol visual analogue scale (EQ_VAS)) of the elderly in Korea. Methods: This study was based on 3,903 subjects aged 65 years or more who participated in the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2012. The HRQoL was analyzed by various factors (general characteristics, health habits, mental health, chronic diseases, nutrient intakes). SPSS statistics for complex samples (Windows ver. 21.0) was used. Results: The HRQoL was higher in the males, those with higher educational level or higher income level while it was lower in those belong to single households. In particular, the EQ_5D was significantly higher in the group who reported walking practice, moderate physical activity (male), and the group who reported no vigorous physical activity (female). The EQ_VAS was significantly higher in the group who reported walking practice. Both EQ_5D and EQ_VAS were significantly lower in the group with stress, melancholy, suicidal thinking, and osteoarthritis. EQ_5D was significantly lower in the group with < 75% Estimated Energy Requirements (EER) in energy intake, and with < Estimated Average Requirements (EAR) in iron or niacin intake. A stepwise regression analysis revealed that i) higher educational level (male), and good self-rated health status significantly increased the EQ_5D, ii) age, alcohol intake (male), melancholy (female), suicidal thinking, osteoarthritis, and niacin intake deficiency (male) significantly decreased the EQ_5D, iii) higher income level (male) and good self-rated health status significantly increased the EQ_VAS, and iv) age (male), stress, suicidal thinking (female) and osteoarthritis significantly decreased the EQ_VAS. Conclusions: This study suggested that general characteristics, mental health, osteoarthritis, and niacin intake were associated with the HRQoL. Prospective research of long-term control is needed to establish the causal relationship between factors and the HRQoL.

Analysis of Health Care Service Trends for The Older Adults Based on ICT (국내외 ICT기반 노인 건강관리 서비스 동향분석)

  • Lee, Sung-Hyun;Hong, Sung Jung;Kim, Kyung Mi
    • Journal of the Korea Convergence Society
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    • v.12 no.5
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    • pp.373-383
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    • 2021
  • Our society is aging rapidly. In this super-aged society, the increase in healthcare costs are considered a national problem that undermines the sustainability of social security. Various services for healthcare for the elderly have been promoted to address this. However, most of them have focused on healthcare after the outbreak of chronic diseases and lack preventive healthcare. Most of the preventive healthcare projects are only pilots. In this paper, the current status of health care services for senior citizens at home and abroad was analyzed and based on this, the limitations and improvements were analyzed to propose the establishment of IoT-based Total Silver Care Center. IoT-based Total Silver Care Center may be conveniently monitored the health status of the elderly through various sensors, medical devices, and smart bands. And based on this, it can improve the quality of nursing services through time-saving and work efficiency of nursing providers. In addition, health care interventions may be provided in a timely manner if there is a change in the health status of users. And real-time imaging systems can help overcome mental difficulties.

Increased Youth Single-person Households and Solitary Deaths realized by College Students (대학생이 인식한 청년 1인 가구 및 청년 고독사 증가 현상)

  • Park, Su-Sun
    • Journal of Digital Convergence
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    • v.16 no.12
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    • pp.635-640
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    • 2018
  • The study conducted a Focus Group Interview (FGI) on college students to identify single-person households and Solitary Deaths of single-person households recognized by college students. This can be provided as basic data to address problems in single-person households and social problems such as future youth solitary death and will contribute to building a social safety net. This study conducted FGI to analyze data for five fourth graders majoring in social welfare. In the case of involuntary independent living, the high poverty and unemployment rate of single-person households was cited as the cause of economic instability, housing problems and emotional relationship formation. He said that he thinks about young loneliness because he has vague fears about what happens in the media and what can happen to them. As the number of young single-person households will inevitably increase in the coming months and economic difficulties are the biggest problem and the biggest cause of young solitude, institutional support is needed first, especially for housing costs.

STUDY ON THE RELATIONSHIP BETWEEN SEROTONIN SYSTEM AND PSYCHOPATHOLOGY IN TOURETTE'S DISORDER (Tourette씨병의 Serotonin계와 정신병리와의 상호관계에 관한 연구)

  • Cho, Soo-Churl;Shin, Yun-O;Suh, Yoo-Hun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.77-91
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    • 1996
  • In order to elucidate the biological etiology and the effects of comorbidity on biological variables in tic disorders, plasma serotonin (5-hydroxlfryptamine, 5-HT) and 5-hydroxy- indoleacetic acid (5-HIAA) we.e measured in 87 tic disorders and 30 control subjects. The 87 tic disorder were composed of 45 Tourette's disorder(TS), 22 chronic motor tic disorders (CMT) and 20 transient tic disorders (TTD). Among these patients,43 patients were pure tic disorder (PT), 28 subject also had attention deficit hyperactivity disorder (T+ADHD) and 16 subjects had obsessive compulsive disorders (T+ OCD) as comorbid disorders. The results are summarized as follows : 1) Plasma 5-HT levels showed significant positive correlations with plasma 5-HIAA levels (Pennon r=0.77, p<0.05). 2) Plasma 5-HT and 5-HIAA levels showed no significant correlation with age in tic disorders. 3) Plasma 5-HIAA and 5-HT levels showed no significant correlations with age in control subjects. 4) There was significant difference in plasma 5-HT levels among TS, CMT, TTD and control groups (ANOVA F=34.48, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed significant differences between control and TS, control and CMT, control and ITD groups. But, post-hoc test showed no significant differences between TS and CMT, TS and TTD, CMT and TTD groups. 5) There was significant difference in plasma 5-HIAA levels among TS, CMT, TTD and control groups (ANOVA F=26.48, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed significant differences between control and TS, control and CMT, control and TTD groups. But, post-hoc test showed no significant differences between TS and CMT, TS and TTD, CMT and TID groups.f) There was significant difference in plasma 5-HT and 5-HIAA levels among PT, T+ADHD, T+OCD and contol groups (ANOVA 5-HT, F=37.59, df=3, 113, p<0.01, 5-HIAA, F=27.37, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed signiscant differences between control and PT, control and T+ADHD and control and T+OCB. But, post-hoc test showed no significant differences between PT and T+ADHD, PT and T+ OCD and T+ADHD and T+ OCD. These results show that decreased 5-HT and 5-HIAA levels may play a role in the genesis of tic disorders, but these findings have no significant correlations with the severity of tic disorders. And the comorbid disorders of tics may have minimal effects on the biochemical abnormalities. Future studies must be focused on the effects of serotonin agonists and antagonists on tic disorders and molecular biological methodology may enhance to elucidate the mechanisms of these abnormal findings.

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Clinical Applications and Efficacy of Korean Ginseng (고려인삼의 주요 효능과 그 임상적 응용)

  • Nam, Ki-Yeul
    • Journal of Ginseng Research
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    • v.26 no.3
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    • pp.111-131
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    • 2002
  • Korean ginseng (Panax ginseng C.A. Meyer) received a great deal of attention from the Orient and West as a tonic agent, health food and/or alternative herbal therapeutic agent. However, controversy with respect to scientific evidence on pharmacological effects especially, evaluation of clinical efficacy and the methodological approach still remains to be solved. Author reviewed those articles published since 1980 when pharmacodynamic studies on ginseng have intensively started. Special concern was paid on metabolic disorders including diabetes mellitus, circulatory disorders, malignant tumor, sexual dysfunction, and physical and mental performance to give clear information to those who are interested in pharmacological study of ginseng and to promote its clinical use. With respect to chronic diseases such as diabetes mellitus, atherosclerosis, high blood pressure, malignant disorders, and sexual disorders, it seems that ginseng plays preventive and restorative role rather than therapeutics. Particularly, ginseng plays a significant role in ameliorating subjective symptoms and preventing quality of life from deteriorating by long term exposure of chemical therapeutic agents. Also it seems that the potency of ginseng is mild, therefore it could be more effective when used concomitantly with conventional therapy. Clinical studies on the tonic effect of ginseng on work performance demonstrated that physical and mental dysfunction induced by various stresses are improved by increasing adaptability of physical condition. However, the results obtained from clinical studies cannot be mentioned in the indication, which are variable upon the scientist who performed those studies. In this respect, standardized ginseng product and providing planning of the systematic clinical research in double-blind randomized controlled trials are needed to assess the real efficacy for proposing ginseng indication. Pharmacological mode of action of ginseng has not yet been fully elucidated. Pharmacodynamic and pharmacokinetic researches reveal that the role of ginseng not seem to be confined to a given single organ. It has been known that ginseng plays a beneficial role in such general organs as central nervous, endocrine, metabolic, immune systems, which means ginseng improves general physical and mental conditons. Such multivalent effect of ginseng can be attributed to the main active component of ginseng,ginsenosides or non-saponin compounds which are also recently suggested to be another active ingredients. As is generally the similar case with other herbal medicines, effects of ginseng cannot be attributed as a given single compound or group of components. Diversified ingredients play synergistic or antagonistic role each other and act in harmonized manner. A few cases of adverse effect in clinical uses are reported, however, it is not observed when standardized ginseng products are used and recommended dose was administered. Unfavorable interaction with other drugs has also been suggested, which the information on the products and administered dosage are not available. However, efficacy, safety, interaction or contraindication with other medicines has to be more intensively investigated in order to promote clinical application of ginseng. For example, daily recommended doses per day are not agreement as 1-2g in the West and 3-6 g in the Orient. Duration of administration also seems variable according to the purpose. Two to three months are generally recommended to feel the benefit but time- and dose-dependent effects of ginseng still need to be solved from now on. Furthermore, the effect of ginsenosides transformed by the intestinal microflora, and differential effect associated with ginsenosides content and its composition also should be clinically evaluated in the future. In conclusion, the more wide-spread use of ginseng as a herbal medicine or nutraceutical supplement warrants the more rigorous investigations to assess its effacy and safety. In addition, a careful quality control of ginseng preparations should be done to ensure an acceptable standardization of commercial products.