• Title/Summary/Keyword: 자문조정 정신의학

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Consultation - Liaison Psychiatry and Psychodynamics (자문조정 정신의학과 정신 역동)

  • Kim, Hyun-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.1
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    • pp.3-7
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    • 2002
  • The author reviewed the historical background of development of consultation-liaison psychiatry along with the psychosomatic medicine. Historically consultation-liaison psychiatry has developed over the past 70 years as an outgrowth of general hospital psychiatric units, and the psychodynamic approach including psychoanalysis has influenced to the development of the consultation-liaison psychiatry. Through the review, the author suggested psychodynamic understandings as a basic tool for the practicing of medical psychotherapy.

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Alcohol Use Disorder in Consultation-Liaison Psychiatry (자문 조정의학에서의 알코올 사용 장애)

  • Seo, Jeong-Seok
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.1
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    • pp.15-19
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    • 2011
  • Alcohol is so-called "a magic bullet" affecting on the various organs and central and peripheral nervous systems and causes mental illness as well as physiological and psychological dependence. Also, alcohol problem is related with serious social problems including family violence, suicide, loss of job and crimes. Because alcohol use disorder is a common cause of consultation and liaison in general hospital, we could consider alcohol use disorder of one of psychosomatic disorder. Thus, I reviewed the prevalence, rate of consultation, and general consultant and treatment issues in treating patients with substance use disorder in a psychosomatic medicine.

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Past, Present, and Future of Psychosomatic Medicine in the Field of Korean Medical Education (한국 의학 교육에서 정신신체의학의 과거와 현재 그리고 미래)

  • Kim, Eui-Joong
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.14-17
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    • 2012
  • There were several documents that might reflect the great concern on the education of psychosomatic medicine in medical school from the 1960s. But the hour of class and proportion of psychosomatic medicine have been quite small among the total lecture time of psychiatry. Notwithstanding the importance of biopsychosocial perspective in practice and research there have been no agreement on the goal and content of teaching psychosomatic medicine in the medical school curriculum. Consultation-liaison psychiatric activity in the hospital were currently under-developed and educational content and process were not systematic. We should have established the goal of psychosomatic education in the medical school that includes making doctor who could not only cure disease but also care the ill patients. And we should develop the curriculum that covers essential area of psychosomatic medicine and checking system to monitor the process of education. With the continuance of psychosomatic perspectives from medical school education to clinical subspecialty we can make progress in this field.

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Adverse Effect of Newer Antidepressant : Nausea and Vomiting, Weight Gain, Sexual Dysfunction - Mechanisms, Epidemiology, and Pharmacological Management - (새로운 항우울제의 부작용: 오심 및 구토, 체중증가, 성 기능장애 - 발병기전, 역학, 약물학적 처치를 중심으로 -)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.81-92
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    • 2013
  • Newer antidepressants are commonly used in clinical practice to treat psychiatric disorder and psychosomatic disorder including chronic pain syndrome, fibromyalgia, headache. However there are many unexpected adverse effects of these drugs such as nausea and vomiting, weight gain, sexual dysfunction. These are 3 most well-recognized common adverse effects of newer antidepressant and are most common causes of treatment failure. I reviewed mechanisms, epidemiology, and pharmacological management of these adverse effects of newer antidepressants. In this paper, newer antidepressants include selective serotonin reuptake inhibitor(fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor(venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor(bupropion), noradrenergic and specific serotonergic antidepressant(mirtazapine), and reversible inhibitor of MAO-A(moclobemide). I suggest that psychiatrists and clinicians in the psychosomatic field should know mechanisms, epidemiology, and management of these common and well-recognized adverse effects of newer antidepressants. Therefore it will be helpful to recognize easily and treat well for patients with psychiatric disorder and psychosomatic disorder using newer antidepressants.

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A Study on the Characteristics and Consultation Type of Inpatients Referred for Delirium and Depressive Disorder (섬망 및 우울장애로 자문 의뢰된 입원환자의 임상적 특징 및 의뢰 형태에 관한 연구)

  • Seong min Lee;Seung-Ho Ryu;Jee Hyun Ha;Hong Jun Jeon;Doo-Heum Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.10-18
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    • 2023
  • Objectives : The purpose of this study is to investigate the characteristics of patients referred for delirium and depressive disorder and to find direction of improvement of consultation-liason psychiatry in general hospital. Methods : We performed a retrospective computed chart review of the 4,966 inpatients hospitalized at Konkuk University Hospital who were referred to the Department of Psychiatry from August 1, 2005 to December 31, 2011. Results : Depressive disorder shows the order of frequency of consultation type Parallel-Complementary-Mending. Delirium shows the order of frequency of consultation type Mending-Parallel-Complementary. When comparing 'follow up consultation' and 'without follow up consultation' group within the depressive disorder, the proportion of men in the 'follow up consultation' group was higher. In the analysis of the consultation type, the 'follow up consultation' group showed the order of consultation type Parallel-Mending- Complementary, and type Parallel-Complementary-Mending in the 'without follow up consultation' group. When comparing 'follow up consultation' and 'without follow up consultation' group within the delirium, the proportion of the surgical field in the 'follow up consultation' group was higher. In the analysis of the consultation type, both group showed the order of consultation type Mending-Parallel- Complementary. Conclusions : Doctors in each department and psychiatrists should pay attention to delirium symptoms that may occur in surgical inpatients and preventive measures should be taken. Screening tests should be conducted in medical patients to properly evaluate coexisting psychiatric diseases. Risk factors of Delirium and Depressive disorder should be identified from the time of hospitalization, and actively discussing treatment plans and early interventions could improve the quality of medical services.

Psychosomatic Management of Medically Ill Children and Adolescents (신체질환이 있는 소아청소년의 정신신체의학적 관리-총론)

  • Lee, Moon-Soo;Joe, Sook-Haeng
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.1
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    • pp.17-24
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    • 2008
  • Psychosomatic medicine is also known as consultation-liaison psychiatry. Pediatric consultation-liaison psychiatry is composed of all consultation, liaison, diagnostic, therapeutic support and research activities carried out by psychiatrists and other mental professionals in pediatric ward to provide mental health services to physically ill pediatric patients. As the differences in the basic concepts of disease models between psychiatry (psychosocial model) and pediatrics(biomedical model) exist, active communication between the child psychiatrist and pediatric medical staffs is required. Although the general guidelines are similar, there are specific considerations for consultation in children and adolescents. Much work is still needed to identify empirically supported treatments which are effective for managing a board range of psychosocial difficulties in children and adolescents.

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Therapeutic Approaches to the Patients Who Were Referred for Psychiatric Consultation from Medical Departments - Focused on Evaluation and Understanding - (정신과에 의뢰된 내과계 환자들에 대한 치료적 접근 -환자에 대한 평가와 이해 -)

  • Lee, Jung-Ho;Lee, Gi-Chul
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.75-80
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    • 1993
  • To understand and evaluate the patients who were referred for psychiatric consultation from medical departments, the authors reviewed the concept of disease, psychological reaction to disease, problems on psychiatric diagnosis and evaluation which were encountered at the medical ward. In addition, we reviewed what psychiatrists should do during consultation.

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The Past, Present and Future of Korean Research in Psychosmatic Medicine (한국 정신신체의학연구의 과거와 현재 그리고 미래)

  • Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.9-13
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    • 2012
  • Psychosomatic medicine is a part of medicine which is to find the effect of psychological, behavioral, and medical factors on the human body and disease. In the early $20^{th}$ century, the idea of psychogenesis had been developed and resulted in the concept of psychosomatic disease which was believed to be caused by psychological factors. However a multifactorial model of illness developed and it allowed illness to be viewed as a result of biopsychosocial interactions. The following have been highlighted by consultation-liaison psychiatry. Psychosomatic medicine has addressed stress and psychiatric factors which affect the etiology, course, and treatment of medical disorders. Moreover it contributes the growth of other related disciplines such as psychoneuroendocrinology, psychoimmunology, behavioral medicine, health psychology and quality of life research. Nowadays, psychosomatic field becomes enlarged because medical and surgical departments have been developed rapidly, and research methods and tools have brought forth rapid progress and advance in medical science. Therefore the author reviews the past and present psychosomatic researches and suggests the future of psychosomatic research in Korea.

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The Investigation Regarding the Psychiatric Consultation of the Inpatient from General Hospital (일 종합병원 입원 환자의 정신과 자문 의뢰의 최근 3년간의 특성에 대한 연구)

  • Lee, Soo-Jin;Lee, Joong-Kwaun;Wang, Kwuan-Shu;Kim, Jung-Gee;Cho, Dong-Hwan;Kim, Hyun-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.49-59
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    • 2005
  • Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.

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DISASTER PSYCHIATRY IN CHILDREN & ADOLESCENTS (소아 ${\cdot}$ 청소년의 재해정신의학)

  • Lee, So-Young Irene
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.38-46
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    • 2002
  • Disaster psychiatry is a new emerging area of psychiatry, in which psychiatrists help to minimize psychological impact of a disaster and to reduce secondary morbidities. In our society, more children and adolescents are facing disasters nowadays. Thus, the necessity for the disaster psychiatry is increasing. After a trauma, children express various symptoms in relevance to their age, development, and their environmental support. The recovery from the disaster and its long-term effect are also influenced by those factors. Psychiatric intervention in a disaster consists mainly of crises intervention and supportive psychotherapy, which includes counseling the victims, educating and providing information to the public, providing support and consultation to the community, and referring of at-risk or severely impaired individuals for more intensive clinical evaluation and care. In addition to a summarized concept of disaster psychiatry, this article presents the adverse psychological effects of children and adolescents exposed to disaster and issues related to the psychiatric intervention.

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