• Title/Summary/Keyword: 자문 조정 정신의학

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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 Current Status and Changing Pattern for 5 Years of Psychiatric Consultation in a General Hospital (일 종합병원에서의 자문 현황과 5년 추이에 대한 고찰)

  • Seol, Jang-Woo;Lee, Sang-Chul;Kim, Hyun-Chul;Hong, Sang-Eui;Lee, Tae-Byoung;Lee, Sang-Kyu;Kim, Do-Hoon;Son, Bong-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.2
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    • pp.75-84
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    • 2005
  • Objectives : This study was conducted to look over the current status of psychiatric consultation in a general hospital. Methods : We analyzed 664 medical records : 317 in 2002 and 347 in 1997, and compared the records of 1997 and 2002. Results 1) The average age of the patients increased from 45.9 years(1997) to 53.2 years of age (2002). Dividing the referred patients into 3 age-brackets as below 40, between 40 and 60, and above 60, the number of patients in the age group above 60 was significantly increased, more prominently in women. 2) Overall consultation rate was 2.29% in 2002 and 2.2% in 1997 .44.2% and 57.1% of the whole referrals were from the department of internal medicine in each year, and the department of rehabilitation medicine was leading in consultation rate in both years. 3) 'Mood disorders' and 'Substance related disorders' were the most frequent diagnoses in 2002 and 1997 respectively. 4) Use of psychotropic drugs was the most frequent recommendations of psychiatric consultation, in both years, and the most frequently prescribed drugs were anti-anxiety drugs in both years. The use of SSRI and atypical anti-psychotics were increased, while the use of typical anti-psychotics was decreased significantly in 2002. Conclusion : In 2002, compared with 1997, the average age of the patients was increased, and the consultation of the patients with the diagnosis of 'mood disorders' and 'cognitive disorders' was done more frequently than in 1997. The recommendation to use psychotropic drugs was well accepted, but the concern to diagnostic procedure was relatively low.

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Psychosomatic Medicine : Present and Future Prospects (정신신체의학의 현재와 미래의 전망)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.14-24
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    • 1993
  • The author discussed present problems and future prospects of psychosomatic medicine in clinical, educational, research, and social aspects. In general, psychosomatic field. particularly. consultation-liaison(C-L) psychiatry in Korea seems to remain on early developmental phase. However, positive change in the general publics' and societal view of psychiatry, specialization of medicine and development of medical technology, implementation of delivery system in medical care could contribute to development of this field. In future, clinically, liaison activity will be more activated. and this field will be developed as main subspecialty of psychiatry. In addition. C-L psychiatry will be subspecialized. and prevention and humanization of medical care could be more emphasized. In education. the main place of education for medical students and psychiatric residents will be changed from closed ward to general ward in which consultation-liaison activity can be performed. In research. consultation liaison model suitable for Koreans will be developed and studies on disease mechanism will be more promoted. In social aspects, this field could influence the general publics' view of psychiatry and change the whole areas of medicine and society toward integration. In order to achieve these goals, medical insurance system and cost relevant to C-L activity should be essentially improved.

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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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Psychosomatic Integrative Care for Psychosocial Distress of Patients With Breast Cancer (유방암 환자의 정신사회적 디스트레스에 대한 정신신체의학적 통합치료)

  • Yang, Chan-Mo;Jang, Seung-Ho;Lee, Hye-Jin;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.77-85
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    • 2021
  • Breast cancer is the most prevalent oncological disease among women. Various psychosocial distress is common at the diagnosis, treatment, and posttreatment phase of breast cancer. For the treatment of breast cancer, not only medical treatment but also psychosomatic integrative care will be needed. Patients with breast cancer may lead to increased vulnerability to stress, adjustment disorder, anxiety disorder, and depressive disorder, and these psychiatric diseases and conditions are associated with recurrence or exacerbation of breast cancer. Psychosocial treatment of anxiety and depression could increase the quality of life of patients and decrease the recurrence and progression of breast cancer. In this article, we reviewed 5 clinical breast cancer survivorship guidelines focused on psychosomatic integrative care including psychosocial treatment and alternative treatment for psychosocial distress. Because 5 treatment guidelines were using various definitions of evidence, we confirmed evidence of various psychosocial treatments for patients with breast cancer based on the definition of evidence by the US Preventive Service Task Force (USPSTF) guideline. We also reviewed the effect size of psychosocial treatment for anxiety, depression, mood, and quality of life in patients with breast cancer. This article discusses the barrier to the delivery of psychosomatic integrative care and suggests integrative care planning for breast cancer. Multi-disciplinary teams, patient's needs assessment, information technology support, patient and caregiver engagement, planned periodic monitoring of psychosocial distress by a psychosomatic specialist or consultation-liaison psychiatrist are recommended as key features of a psychosomatic integrated care plan.

The Importance of Treatment for the Patients with Chronic Pain (만성통증 환자 치료의 중요성)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.252-255
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    • 1999
  • Numbers of patients who have chronic pain seem to be increasing even in the psychiatric practice. One report in Korea showed more than 40% of psychiatric patients who visited out-patient clinic were suffered from chronic pain and one third of those patients were needed treatment for the on-going pain. For evaluating and treating those patients the charateristics of illness behavior should be understood. Abnormal Illness behavior was found as one of the most influential factors which led symptoms complicated and chronified. This symposium was planned to illustrate how to manage the patients whose pain are associated with arthropathy and connective tissue diseases, neuropathic pain and headache more effectively and efficiently. So, It is hoped to get fruitful knowledges for the management of chronic pain in the scope of consultation-liaison psychiatry.

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Delirium after Head Trauma at Psychiatric Consultation (두부 외상 후 섬망의 자문 정신 의학적 고찰)

  • Kim, Hyon-Chul;Lee, Sang-Chul;Kim, Do-Hoon;Lee, Sang-Kyu;Hong, Seung-Gwan;Son, Bong-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.15-22
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    • 2004
  • Objectives: Delirium after head trauma results in various cognitive and behavioral dysfunction. This study aimed at developing and validating a predicitive model for clinical improvement after delirium based on precipitating factors during hospitalization Method: Data were collected on 45 patients who developed delirium after head trauma using 5 year retrospective design, based on reviews of medical charts including psychiatric consultation reports. The differences of the group who sustained residual symptoms of delirium(The RS group) and the group of full recovery(The FR group) at 4 week follow-up visits were compared by motoric type of delirium, socio-demographic variables, neuroimaging variables and clinical variables of interest. Result: There was significant difference in reason for initial consultation between two groups, in terms of hyperactivity(p<.01). The presence of compensation claim, subcortical gray matter lesion was significantly associated with the RS group(p<.05). Total length of intensive care unit(ICU) admission and of hospital stay were significantly longer in RS group than FR group(p<.01). Conclusion: This study shows that hyperactivity on initial consultation, compensation claims, specific brain lesion were altogether significant factors in explaining prolonged duration of delirium after head trauma. A simple predictive model based on the presence of precipitating factors might be used to identify delirious patients at high risk for prolonged cognitive dysfunction. Early psychiatric intervention would be required for evaluating efficacious management and shortening admission period.

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Mental Health Issues in Solid-Organ Transplant Recipients; Pre-, Peri-, and Post-Transplant Phases (고형장기이식 환자의 정신건강: 이식의 시기별 이슈)

  • Yeonjin Jung;Jee In Kang
    • Anxiety and mood
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    • v.19 no.2
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    • pp.37-47
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    • 2023
  • This review article explores the psychological characteristics, comorbid mental disorders, and psychosocial assessments throughout the solid organ transplant journey, spanning the pre-transplant, peri-transplant, and post-transplant phases for transplant recipients. The psychological burden and anxiety in the pre-transplant phase are high for organ failure patients with complex physical difficulties who are deciding to undergo transplantation and are on the waiting list. The pre-transplant psychosocial evaluation covers various aspects, including the patient's readiness, awareness of, and commitment to transplant treatment, medical compliance, psychopathological conditions such as cognitive function and personality disorders, lifestyle factors, including substance abuse, as well as various psychosocial factors like social support. During the peri-transplant phase, mental health problems such as postoperative delirium should be carefully recognized and addressed. After transplantation, it is essential to assist patients in coping with the various stressful experiences they encounter, manage psychiatric symptoms such as depression, anxiety, and insomnia, and improve treatment adherence and quality of life during long-term care for the transplanted organ. Managing psychiatric problems in post-transplant patients requires a deep understanding of immunosuppressant medications and a keen awareness of associated risks, including adverse effects and potential drug interactions. This comprehensive review emphasizes the significance of proactive mental health care and psychosocial evaluation, highlighting the necessity of a multidisciplinary approach to enhance the quality of life and overall success of transplant patients throughout all phases of transplantation.

Drug-drug Interactions between Psychotropic Agents and Other Drugs in Physically Ill Patients - Experience of Consultation-liason in Korea University Hospital - (내외과계 환자의 정신과 약물치료에서 약물-약물 상호작용 - 고려대학교 부속병원의 자문조정의 경험을 통하여 -)

  • Lee, Min Soo;Lee, Heon-Jeong
    • Korean Journal of Biological Psychiatry
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    • v.6 no.1
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    • pp.49-66
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    • 1999
  • Polypharmacotherapy, both psychotropic and nonpsychotropic, is widespread in various situations including psychiatric hospitals and general hospitals. As the clinical practice of using more than one drug at a time increase, the clinician is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. The objective of this review is evaluation for drug-drug interactions often encountered in psychiatric consultation. Drug interactions can be grouped into two principal subdivisions : pharmacokinetic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug moves from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In psychiatric consultation, these two subdivisions of drug interactions between psychotropic drugs and other drugs are likely to happen. We gathered informations of the drugs used in physically ill patients who are consulted to psychiatric department in Korea University Hospital. And we reviewed the related literatures about the drug-drug interactions between psychotropic drugs and other drugs.

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