• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.9 no.1
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• pp.13-25
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• 1998

Aim：We think that the most important etiology in parent abuse is the psychodynamic and psychopathology in the family. So, we investigated the adolescents being admitted in SNMH, whose chief complaints were parent abuse. We were trying to explore families psychodynamic and psychopathology, especially mother-child interaction and to differentiate them in according to developmental psychopathology. Method：Our objects were the adolescent patients admitted in SNMH from 1987 to 1997 because they attacked parents verbally and physically. We examined 21 adolescents except those with psychosis, organic mental disorder, autism and mental retardation by means of interview or chart review. Result and Conclusion：The number of male patients was 14 and the number of female patients was 7. The most common diagnosis was conduct disorder and borderline personality disorder. The mean age was in the mid-teens. We observed 4 subgroups that were divided developmentally in object relation. 1) Symbiotic group with mother：(1) They did not separate and remain in symbiotic relationships with their mothers based on insecure attachment. Fathers were abscent emotionally and physically, and their mothers were prominent in close relationships with the patients in their family , where as the patients were the only man in the family. Adolescents entered the second separation-individuation. They expressed anger and internal tension involved with the close attachment with their mothers and also attempted separation from their mothers through physically attacking them. (2) These patients had suffered from physical illness and developmental delay since birth. Therefore the parents overprotected their children. The children had persistent infantile omnipotence and fantasies of power, so they could not deal with unrealistic states, adapt to reality, and depended on their parents overtly. They easily acted out unless their demands were fulfilled. 2) Borderline personality disorder：We observed deficiencies in care taking. Their parents had personality problems and immaturity. They coulden’t help their children to be separated in the rapproachment phase. Their conflict about dependence-independence was revived in the second separation-individuation adolescent period. We understand parent abuse as an attempt to overcome the conflict. 3) Conduct disorder：They did not build up basic attachment with their parents. They think of their parents as only a means of fulfilling their needs. When patients’ need were not fulfilled and remained in a conflicted state, they attacked their parents, unable to control their aggressions and impulses.

• Journal of Hospice and Palliative Care
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• v.15 no.1
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• pp.10-17
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• 2012

Purpose: This study was conducted to identify the perception regarding palliative care among Korean doctors and referral barriers toward palliative care for terminal cancer patients. Methods: Between May and June 2010, 477 specialists mainly caring cancer patients using a web-based, self-administered questionnaire. Results: A total of 128 doctors (26.8%) responded. All respondents (100%) deemed palliative care a necessary service for terminal cancer patients. More than 80% of the respondents agreed to each of the following statements: all cancer centers should provide palliative care service (80.5%); all terminal cancer patients should receive concurrent palliative care along with anti-cancer therapies (89.1%) and caring for terminal cancer patients requires interdisciplinary approach (96.9). While more than 58% of the respondents were satisfied with their performance of physical and psychological symptoms management and emotional support provided by patient's family members, 64% of the responded answered that their general management of the end-of-life care was less than satisfactory. Doctors without prior experience in referring their patients to palliative care specialists accounted for 26.6% of the respondents. The most common barrier to hospice referral, cited by 47.7% of the respondents, was "refusal of patient or family member", followed by "lack of available palliative care resources" (46.1%). Conclusion: Although most doctors do recognize the importance of palliative care for advanced cancer patients, comprehensive and sufficient palliative medicine, including interdisciplinary cooperation and end-of-life care, has not been put into practice. Thus, more active palliative consultation or referral is needed for effective care of terminal cancer patients.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.2
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• pp.163-174
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• 1997

This study was to know the influence of familial environment and moral development on conduct disorder. Subjects were composed of 47 male and female patients with conduct disorder(patients group), 113 general male and female students(normal group), and 173 juvenile prisoners(JP group). The Korean Form of the Family Environment Scale(FES) was used to assess the family environment of the subjects and the Korean Defining Issues Test(DIT) was used to assess the moral development. Conduct disorder was diagnosed with the DSM-III-R criteria for conduct disorder. The influence of familial environment and moral development on conduct disorder was analyzed with ANOVA and the differences among groups were verified with Scheffe test. There was no difference in the socioeconomic status and the physical abuse by the parents among the three groups. But the rates of divorce or separation of the parents were significantly highest in the JP group and higher in the patients group than in the normal group. Especially the subjects of the JP group experienced the divorce or separation of their parents during the preschool or the elementary school periods. In regard to the family environment, there was no difference among the three groups in the Subscales of Expressiveness, Independence, Intellectual-cultural orientation, Moral-religious emphasis, Organization, and Control. ‘Cohesion Subscale’ was significantly higher in the normal group than in the JP group. ‘Conflict Subscale’ was significantly higher in the JP and patients groups than in the normal group. ‘Achievement orientation Subscale’ was significantly lower in the JP group than in the patients and normal groups. ‘Activerecreational orientation’ was significantly lower in the normal group than in the JP and patients groups. In gegard to the moral developmental stage, the lower moral developmental step was higher in the JP and patients groups than in the normal group. The higher steps were significantly higher in the normal group than in the JP group. There was no significant correlation between the degree of ‘Moral-religious emphasis Subscale’ and the moral development. The clinical implication and limitation of present study were listed and discussed.