• Title/Summary/Keyword: 정신과적 진단

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The Characteristics and Types of Psychiatric Consultation for Insomnia Symptom in Hospitalized Patients (불면증으로 의뢰된 입원환자의 임상적 특징 및 협진 유형 분석)

  • Jeon, Hansol;Ryu, Seung-Ho;Ha, Jee Hyun;Jeon, Hong Jun;Park, Doo-Heum
    • Sleep Medicine and Psychophysiology
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    • v.25 no.2
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    • pp.68-73
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    • 2018
  • Objectives: The purpose of this study was to explore insomniac demographic characteristics and the type of consultation provided to hospitalized patients asked to the Department of Psychiatry for insomnia and to compare patient insomnia characteristics by consultation type. Methods: We performed a retrospective chart review of 4,966 patients who were hospitalized from August 1, 2005 to December 31, 2011 that received consultation in the Department of Psychiatry. Among them, 236 patients were referred for insomnia. We compared the differences in demographic characteristics and types of consultation between the insomnia patient group and other patient group. We also compared the difference between demographic characteristics and type of consultation by dividing total subjects into 'with reconsultation' and 'without reconsultation' groups. Results: Our results came from the analysis of 9,689 consecutive consultation requests. There were 4,966 patients that participated in the study over 6 years and 6 months. The overall consultation rate was 3.3% of all admissions and insomnia patients comprised 4.8% of those. The ratio of re-consultation for insomnia was 27.5%. There was no significant difference in mean age between the insomnia 'with reconsultation group' and the insomnia 'without reconsultation group', but the 'with reconsultation' group had significantly more male patients and medical patients than the 'without re-consultation' group. For insomnia patients, consultation types were in the order of Mending request (51.3%), Paralle request (36.6%), Complementary request (9.0%) and this composition differed from that of total admission patients. Conclusion: Hospitalized patients referred for insomnia showed a higher proportion of male patients, lower rates of re-consultation compared with other patients, and most of these were for secondary insomnia. Each doctor should be aware of the possibility of inpatient insomnia, conduct positive assessments and referrals as necessary, and psychiatrists who might be asked for consultation need to prepare an active intervention with initial diagnosis and treatment, as well as recommendations for the timing of reconsultation.

REARING PATTERN OF SCHIZOPHRENIC MOTHERS AND THEIR CHILDREN'S BEHAVIOUR PROBLEMS (정신분열병이 있는 어머니의 양육태도와 자녀의 행동문제)

  • Kang, Kyung-Mi;Kwack, Young-Sook;Lee, Sung-Hun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.180-189
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    • 1998
  • Objects:This study is investigated to compare psychopathology and their perceived parental rearing pattern of the children of schizophrenic mother with those of normal control group. The correlation were also assessed between perceived parenting style and problem behaviour Method:Thirty children(age 12-18) of schizophrenic mother and normal control subjects completed self-report questionnaires containing child·adolescent behaviour problem check list(K-CBCL) and Parental bonding instrument(PBI). Result:The result were as follow in the children of schizophrenic mother:1) the mean score of problem behaviour significantly higher than normal control group. 2) Parenting style was perceived to be less caring and more overprotective than in the control subject. 3) there was positive correlation between maternal overprotection and problem behaviour and negative correlation between maternal care and problem behaviour. Conclusion:We succeed in identify that the children of schizophrenic mother have more problems in social adjustment than normal control subjects. Parental rearing style are thought to be significantly negativistic in the children of schizophrenic mother. It is guessed that less caring and more overprotective rearing style of schizophrenic mother could have influence on problem behaviours of their children.

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A Relation between Clinical Characteristics of Cancer Patients on Radiotherapy and Psychiatric Disorders (방사선 치료중인 암환자의 임상적 특징과 정신과 장애의 관련성)

  • Kim, Ho-Chan;Moon, Chang-Woo;Park, Si-Sung
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.134-141
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    • 1999
  • Objects : Cancer patients receiving radiotherapy have many psychological problems. Those problems depend on clinical factors of cancer and the characteristics of patients. This study was designed to estimate the morbidity of psychiatric disorder and to investigate the relationship between psychiatric disorders and clinical variables. Methods : The subjects were 47 patients who had been treated by radiotherapy. Psychiatric disorder was diagnosed according to DSM-IV. The authors assessed the relation between psychiatric disorder and demographic features, clinical features of cancer such as site, duration, frequency of recurrence of cancer, and patients' awareness of disease and expectation of outcome of radiotherapy. Results : 21 patients(44.7%) had a psychiatric disorder. The most common psychiatric disorder were adjustment disorder(66.7%), and the next major depressive disorder(23.8%). There was a significant positive relationship between psychiatric disorder and recurrence of cancer, patients' expectation of poor outcome after radiotherapy. Psychiatric morbidity was significantly low in those who had no evidence of recurrence and who considered radiation treatment as curative. However, site and duration of cancer, patients' awareness about serious illness were not related with psychiatric disorder. Conclusion : Psychiatric disorders are common among cancer patients on radiotherapy. Further clinical attention and effective treatment of psychiatric complication in cancer patients are needed not only for reducing symptoms but for better adjustment.

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Psychological Characteristics of Psychiatric outpatients with High Suicide Risk : Using MMPI-2-RF (정신건강의학과 외래 환자 중 자살 고위험 집단의 심리적 특성 : MMPI-2-RF를 이용하여)

  • Nam, Jisoo;Kim, Daeho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.8-19
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    • 2020
  • Objectives : The purpose of this study was to examine whether the MMPI-2-RF serves as a useful tool to differentiate between the subtypes of high risk of suicide among psychiatric outpatients. Methods : Patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. Their medical records were reviewed retrospectively. And participants were put into 4 groups (Suicide ideation, Suicide attempt, Non-suicidal self-injury, and general psychiatric diagnosis as a control group). For statistical comparison, the MANCOVA with gender as a covariate was used. Results : The results indicated that as previous research with non-clinical sample suggested, psychiatric outpatients with high suicide risk also have significantly higher Emotional/Internalizing Dysfunction, Helplessness/Hopelessness, Suicidal/Death Ideation, Demoralization, Cognitive complaints, Cynicism, Dysfunctional negative thoughts than general psychiatric patients group. But group differences within the high suicide risk patients have not been observed. However, suicide attempt group and NSSI group has higher Behavioral/Externalizing Dysfunction, RC4, AGG than general psychiatric patients group. But there was no difference between suicidal idea group and general psychiatric patients group. Conclusions : There was no group difference observed between all three subtypes, which mean the MMPI2-RF may not be the useful diagnostic tool to navigate high suicide risk subtypes. Even though there was no difference observed in the suicide ideation group, suicide attempt group and NSSI group have higher aggression and externalization. So those indexes could serve as a useful marker to investigate riskiness of suicide related symptoms.

Serum Lipid Profiles after Abstinence in Korean Male Patients With Alcohol Dependence (남성 알코올 의존 환자들에서 금주 치료 후의 혈청 지질 농도 변화)

  • Lee, Seoung-Ho;Park, Woong-Sub
    • Korean Journal of Biological Psychiatry
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    • v.15 no.1
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    • pp.23-28
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    • 2008
  • Objectives : The treatment of alcohol dependence requires maintaining abstinence. However, some previous studies have suggested that the abstinence may increase the cardiovascular risk in patients with alcohol dependence. The aim of the present study was to examine the effect of alcohol abstinence on lipid profile in Korean male patients with alcohol dependence. Methods : Twenty-eight male patients with alcohol dependence were recruited from a psychiatric unit located at Gangneung Dongin Hospital. Lipid profiles of the patients were compared before and after a month of alcohol abstinence. Results : After abstinence of 1 month, high-density lipoprotein(HDL) cholesterol and triglyceride(TG) level was significantly decreased(p=0.000; p=0.0086, respectively). Low-density lipoprotein(LDL) cholesterol level showed a tendency to increase(p=0.066). Total cholesterol level also showed a tendency to decrease(p=0.074). Conclusions : These results show that acute abstinence of alcohol might paradoxically aggravate dyslipidemia in patients with alcohol dependence. Thus, this study shows that more concern associated with cardiovascular risk is needed during short-term abstinence period.

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TIC DISORDER AND OBSESSIVE COMPULSIVE DISORDER IN CHILDHOOD (틱 장애 및 소아기 발병 강박 장애)

  • Hong, Hyun-Ju;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.183-191
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    • 2005
  • Tic disorder including Tourette's disorder is a neurodevelopmental disorder that appears in childhood and characterized by the presence of motor and vocal tics. Childhood-onset obsessive-compulsive disorder (OCD) is suggested to be a phenomenologically and etiologically distinct subtype of OCD, bearing a close genetic relationship to tic-disorders. Tourette's disorder and OCD are comorbid in $40-75\%$ of patients initially diagnosed with either disorder. Basal ganglia and cortico-striato-thalamic circuits are implicated in the pathophysiology of both disorders and these disorders have similar clinical features. Over the past decades, the progress in research on Tourette's disorder and OCD has been extraordinary. This review describes some of important insights from these work, involving these areas : 1) clinical implication 2) genetics and epidemiology 3) brain imaging study 4) neuroche-mistry 5) pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS).

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Analyses of Suicide Victims Admitted via the Emergency Department -Based on Psychiatric Histories, Past Suicidal Attempts and Psychiatric Diagnoses- (응급실을 경유하여 입원한 자살시도자들의 분석 -정신병력, 자살시도력 및 정신과적 진단을 중심으로-)

  • Hur Jae Min;Chun Woo Chan;Min Young Gi;Jung Yoon Seok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.106-115
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    • 2004
  • Purpose: This study analyzed the general features, psychiatric histories, past suicidal attempts and psychiatric diagnoses of suicide victims admitted via the emergency department (ED). Methods: Reviewing the charts of 138 inpatients of suicide attempts admitted via the ED from January 2002 to December 2003, we analyzed various data, including sex, age, season, stressful events, psychiatric histories, previous suicidal attempts, and psychiatric diagnoses during admission, and we used a chi-square test to chart the statistical data. Results: A significant difference was found between 1 st attempts and repeated attempts as to the mechanical methods used for the suicide attempts, There was a significant difference in the kinds of drugs between patients with and without psychiatric histories. In the psychiatric diagnosis, there was a significant difference in AXIS I between patients with and without psychiatric histories. In AXIS II, there was a significant difference between patients with and without psychiatric histories, 1st attempts and repeated attempts. Conclusion: We emphasize the importance of psychiatric consults, treatments, and follow-ups for suicide victims and the emergency physicians' function in helping them to contact psychiatric doctors.

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A Study on Anxiety-Depression and Psycnoticism in Hospitalized Patients (종합병원 입원 환자의 정신 건강 평가)

  • Kim, Jin-Sung
    • Journal of Yeungnam Medical Science
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    • v.9 no.1
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    • pp.54-67
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    • 1992
  • The author studied the mental status of 497 patients admitted in non-psychiatric wards and 42 patients diagnosed as mental disorders by DSM-III-R criteria and admitted in three general hospitals located in Pusan city, using NADS and PSCS. The assessment were obtained from October, 1991 to March, 1992 and the results as follows: The mean ${\pm}$ SD of Anxiety-Depression scores were $34.4{\pm}10.4$ in non-psychiatric patients and $50.0{\pm}18.3$ in psychiatric patients. The psychiatric group had significantly higher scores than non-psychiatric group. The mean ${\pm}$ SD of Psychosis scores were $3.9{\pm}4.4$ in non-psychiatric patients and $20.3{\pm}9.8$ in psychiatric patients. The psychiatric group had significantly higher scores than non-psychiatric group. In the psychosocial factors, dissatisfaction in family atmosphere and acquaintanceship with parellts(P<0.001, relatively), pessimistic in future, present and past self-images(P<0.001, relatively), and yes in previous psychiatric treatment of admission(P<0.01, relatively) had common significant relationships to Anxiety-Depression and Psychosis scores. There were correlationships between NADS scores and PSCS scores(${\gamma}$ = 0.74), past and present self-images(${\gamma}$ = 0.45), present and future self images(${\gamma}$ = 0.45), past and future self-images(${\gamma}$ = 0.34) and family atmosphere and acquaintanceship with parents(${\gamma}$ = 0.49). The regression analysis revealed that present self-image, acquaintanceship with parents, future self-image, past self-image, and family atmosphere, in order of significance were to be descriptive or predicable variances for Anxiety-Depression status. The discriminant analysis according to Anxiety-Depression scores showed that the cases of incorrect classification were 22 for non-psychiatric patient group and 2 for psychiatric patient group.

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Correlations of Cerebellar Function with Psychotic Symptoms and Cognitive Function in Schizophrenic Patients (남자 정신분열병 환자의 소뇌기능과 정신증상 및 인지기능간의 연관성)

  • Kim, Seo Young;Jun, Yong Ho;Kwon, Young Joon;Jeong, Hee Yeon;Hwang, Bo Young;Shim, Se Hoon
    • Korean Journal of Biological Psychiatry
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    • v.14 no.3
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    • pp.184-193
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    • 2007
  • Objectives:There is increasing evidence that the cerebellum plays an important role in cognition and psychiatric symptoms as well as motor coordination. The concept of cognitive dysmetria has been making cerebellar function in schizophrenia the focus of current studies. In other words, disruption in the corticocerebellum-thalamic -cortical circuit could lead to disordered cognition and clinical symptoms of schizophrenia. The purposes of this study were to determine cerebellar dysfunction in male schizophrenic patients semiquantitatively with ICARS and to investigate the clinical and cognitive correlates of ICARS in patients. Methods:We compared the scores of cerebellar neurologic sign using ICARS in 47 male patients with a DSM-IV-TR diagnosis of schizophrenia with 30 gender and age-matched healthy control subjects. The semiquantitative 100-point ICARS consists of 19 items divided into 4 unequally weighted subscores:posture and gait disturbances, kinetic functions, speech disorders and oculomotor disorders. All subjects were also assessed with cognitive function test. Cognitive functions were evaluated by Korean-Mini Mental Status Examination (K-MMSE), Verbal fluency test, and Clock drawing test. The patients were administered Korea version of Positive and Negative Symptom Scale(K-PANSS) to assess the symptom severity. Results:Schizophrenic patients had significantly higher scores on the ICARS than control subjects with posture and gait disturbances, kinetic functions, and oculomotor disorders. They also showed more significant impairments in cognitive function tests than control subjects. There was a significant correlation between ICARS and negative symptoms of patients. In cognitive function test, Clock drawing test was significantly associated with negative symptoms. In addition, Clock drawing test was negatively correlated with the total score of ICARS. Conclusion:In this study, we confirmed that schizophrenic patients have significant impairments in cognitive and cerebellar function, and that those were related with negative symptoms of schizophrenic patients. These results support a role of the cerebellum in schizophrenia. It is meaningful that we used a structured, and reliable procedure for rating neurological soft signs, ICARS. We hope that future prospective studies using a similar design help that rate of neurological sign should have been visible with the progression of illness.

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A PSYCHIATRIC STUDY ON THE CHILDREN WITH RECURRENT ABDOMINAL PAIN (반복적 복통 환아의 정신과적 연구(反復的 腹痛 患兒의 精神科的 硏究))

  • Choi, Jin-Sook;Hong, Kang-E;Seo, Jeong-Kee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.117-129
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    • 1990
  • 35 children(17 boys, 18 girls) with Recurrent Abdominal pain(RAP) without apparent organic causes, referrd from pediatric department of Seoul National University Children's Hospital were studied during 1988. 7. 1 ${\sim}$ 1989. 2. 28. The aims of this study are to examine clinical characteristics of the patients with RAP, to find possible factors influencing the onset and the course of the disorder, to evaluate the psychological status and the relationship with psychiatric diagnoses. The study subjects were compared with the age and sex matched control subjects on measures of social and school functioning, family-environment, behavior traits by CBCL and parent-environment rating scale. All patients and their mothers were interviewed by a child psychiatrist. The results were as follows ; 1) Abdominal pain was found to be more frequent when with a care taker, and related with traumatic life stresses such as separation from parents, death of family members. 2) Family members of the patients with RAP also had a high rate of a history of gastrointestinal dysfunctions with could not be attributed to organic etiologies. 3) Among 35 patients with RAP, 16 were diagnosed as psychiatric disorders. They were adjustment disorders (4), overanxious disorders (4), depression (2), tic disorders (2), attention deficit disorders (2), separation anxiety disorders (1), enuresis (1). 4) On CBCL, the patients with RAP were more internalized, socially less competent and less active compared with the control subjects. 5) According to the parent-environment rating scale, the patients with RAP had more conflicts with their parents about control issues. Family members of the patients with RAP were socially less competent and less abjustable. The parents of the patients with RAP were more affectionate and spent more time with their children but they were unfair and vague on instruction and discipline.

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