• Title/Summary/Keyword: 정신과적 치료

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Psychiatric Treatment of Chronic Pain Disorder (만성 통증장애의 정신과적 치료)

  • Rho, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.256-262
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    • 1999
  • Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

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Neuropsychiatric Aspects of Pulmonary Disease (호흡기 질환의 신경정신과적 측면)

  • Nam, Beom-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.2
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    • pp.45-51
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    • 2009
  • Pulmonary diseases distress millions of people worldwide. Numerous studies have shown an association between pulmonary disease and psychiatric disorders. Despite this, little is known about the treatment of psychiatric disorder in patients with pulmonary disease. The three main goals of this article are 1) to discuss the major disorders such as asthma, chronic obstructive pulmonary disease, hyperventilation, tuberculosis, lung cancer that most clinicians see in practice, 2) to provide an information about psychiatric treatment such as anxiety, depression, psychosis in pulmonary disease, and 3) to provide some clinically relevant suggestions about pharmacologic interactions between pulmonary and psychotropic drugs.

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Psychiatric Preparation of Surgery (수술전 환자들의 정신과적 문제)

  • Chang, Sung-Man;Lee, Sang-Won
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.1
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    • pp.3-7
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    • 2009
  • Psychiatric disorders are quite common in surgical patients. However, surgeons are less likely to refer patients to psychiatrists than other physicians, who also have a tendency to under-recognize psychiatric disorders among their patients. Therefore, a large proportion of psychopathology in surgical patients is either undiagnosed or misdiagnosed and not optimally treated, if treated at all. This column focuses on common psychiatric issues that generally arise in surgical patients and reviews psychiatric issues specific to specialized surgical settings and patients (eg, burn units, obesity surgery).

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Assessment and Treatment of Somatization (신체화의 평가 및 치료)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.149-164
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    • 2000
  • Somatization is regarded as a process rather than a diagnostic entity. It should be emphasized to identify psychopathology rather than to make a choice regarding diagnosis in assessing somatizing patients. Psychiatrists should be aware of the psychosocial cues underlying the patients' physical symptoms. Special skills and strategies are required by nonpsychiatric physicians to facilitate the patients' acceptance of psychiatric treatment. The goal of treatment for somatization is management but not cure. The approach should be flexible, depending on the patients' responses and need. The difficulty in diagnosing and treating somatization is likely to be related to abnormal illness behavior such as the patients' denial of their psychosocial problems and resistance to psychiatric approach. In conclusion, biopsychosocial approach is needed to treat these patients effectively. Psychiatrists should also teach other physicians the interview skill that they could identify these patients as early as possible and facilitate their acceptance of psychiatric treatment.

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AIDS 환자의 신경인지기능 장애

  • Nam, Yun-Yeong
    • RED RIBBON
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    • s.72
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    • pp.9-11
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    • 2006
  • 후천성 면역 결핍 증후군(AIDS, Aquired Immune Deficiency Syndrome)과 사람 면역결핍 바이러스 (HIV, Human Immunodeficiency Virus)관련 질환은 1981년 처음 AIDS가 보고된 이래 전 세계적으로 인류의 건강을 위협하고 있는 공중보건학적 문제이다. 그동안 HIV/AIDS 관련 질환에 대한 치료들은 주로 감염 경로 차단 및 관련된 내과적 질환의 치료에 초점이 맞추어져 왔다. 그러나 AIDS 환자 본인뿐만 아니라 가족, 치료진들은 흔히 HIV 감염으로 인한 심리적인 어려움에서부터 HIV 전파 위험을 높이는 물질 오남용 문제, 우울증, 치매 같은 전형적인 정신과 질환 및 자살에 이르기 까지 다양한 종류의 정신건강 상의 문제들에 자주 직면한다. 이와 같은 신경정신과적 문제들은 치료 결과나 예후, 삶의 질 등에 영향을 미칠 수 있기 때문에 환자의 가족들은 AIDS로 인한 정신과적 질환이나 현상들에 대해 잘 이해하고 적절하게 대처할 필요가 있다.

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Psychosomatic Management of Medically Ill Elderly : Focused on Consultation Psychiatry (신체질환이 있는 노인 환자의 정신신체 의학적 치료 : 자문정신의학을 중심으로)

  • Ryu, Seong-Gon;Kwon, Hee-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.1
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    • pp.25-30
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    • 2008
  • With the rapid growth of geriatric population, geriatric psychiatric consultation has come to play a more important role in recent years. It is necessary to find out characteristics of psychiatric consultation-liaison in elderly and applicate practical guideline of consultation in medical setting. Management of medically ill elderly in psychiatric consultation requires different guideline from that of other age group patient. Because aging and each organ-specific diseases change the pharmacokinetics of psychotropic drugs variably. These pharmacokinetic changes should be considered in psychosomatic treatment in medically ill elderly. The relatively low consultation rates for psychiatric disorders in the elderly indicate that research is needed into factors that both prevent and facilitate elderly patients with psychological symptoms from consulting their general practitioners.

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A Case of Globus Hystericus caused by psychological, digestive disorder (정신과적, 소화기성 원인으로 유발된 Globus Hystericus 치험 1례)

  • Lee, Hyun-Woo;Chang, You-Jin;Hong, Seung-Ug
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.26 no.2
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    • pp.88-97
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    • 2013
  • Objectives : 본 연구를 통해 정신과적, 소화기성으로 유발된 히스테리성 구를 반하백출천마탕과 자음건비탕으로 치료한 1례를 보고하려 한다. Methods : 오심, 불면, 이명, 소화불량, 초조, 두통, 매핵기를 주소로 하는 23세 여성 환자를 대상으로 약 4개월 동안 침구, 반하백출천마탕과 자음건비탕으로 치료하였다. Results & Conclusions : 4개월 동안의 치료 후, 히스테리성 구와 다른 증상들이 소실되었다. 이 논문에서는, 소화기계 장애와 정신 질환 치료를 위해 오랫동안 사용되어온 반하백출천마탕과 자음건비탕을 히스테리성 구 치료에 이용하였다. 결론적으로, 본 연구는 히스테리성 구와 소화기계 장애가 밀접한 관련이 있음과 히스테리성 구에 대한 한의학적 치료의 중요성을 제시하였다.

Psychiatric Treatment of Ruminative Vomiting and the Associated Weight Loss in an Adolescent Boy with Autism : A Case Report (자폐증 청소년에서 체중감소와 연관된 반추적 구토의 정신과적 치료)

  • Shin, Yun-O;Rhee, Moon-Sung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.20 no.1
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    • pp.39-43
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    • 2009
  • We treated the persistent ruminative vomiting of a 13-year-old autistic boy by using a behavioral and psychopharmacological approach in a closed ward. Before the interventions, the patient had lost about 10kg of body weight due to very high-frequency ruminative vomiting. Together with psychopharmacological trials, the psychiatric treatment included a combination of a behavioral approach and food regulation that emphasized food restrictions, and we provided regular light meals. There was a considerable reduction of the ruminative vomiting and 2kg weight gain was achieved during the admission. These therapeutic gains were maintained at the 4-month follow-up assessment and the vomiting symptom reached a near-zero level and the weight loss were recovered by about 8kg. The issues related to the treatment approaches for ruminative vomiting with autism are discussed.

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A Studyof Psychiatric Treatment Compliance in Referred Patients at a General Hospital (자문의뢰된 입원환자의 특성과 정신과 치료 순응도에 대한 연구)

  • Shim, In-Bo;Ko, Young-Hoon;Lee, Moon-Soo;Kim, Yong-Ku;Han, Chang-Su
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.2
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    • pp.66-73
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    • 2011
  • Objectives:The present study investigates the status of inpatient psychiatric consultations at a general hospital in order to find factors that contribute to treatment compliance related to psychiatric consultations. Methods:The subjects were 333 patients who were hospitalized at Korea University Medical Center Ansan Hospital from 1 September 2009 to 31 July 2010.The patients were referred for psychiatric consultation during hospitalization. This study investigates demographic data, request department, referral causes, requestor, psychiatric history and diagnosis, andpsychiatric treatment compliance. Treatment compliance was defined as whether or not the patient had accepted psychiatric treatment during hospitalization or outpatient department(OPD) follow-up. This study ascertains the factors that have impact on compliance, by taking binary logistic regression with compliance and other variables. Results:Among the patients that were offered psychiatric treatment during hospitalization(N=310), treatment compliance was 82.9%. Among the patients that were offered OPD treatment(N=111), compliance was 55.8%. Elderly group(>65 years) showed better compliance to treatment during hospitalization than the younger patient group(OR=4.838, p=0.004). Patients with secondary psychiatric disorders showed better OPD follow-up compliance than patients with secondary psychiatric disorders(OR=8.520, p=.008). Conclusion:Elderly patients showed better compliance for psychiatric treatment during hospitalization. However they commonly have disorders such as delirium and mood disorders that have impact on the patient's physical state, hence further active measures should be carried out. Patients referred due to primary psychiatric disorders showed poor OPD compliance. Therefore clinicians have to suggest multidisciplinary interventions that will improve treatment compliance of such patients.

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Review of Psychiatric Adolescent Inpatient with Dermatologic Consultations (청소년 정신과 입원 환자들의 피부과 자문 의뢰에 관한 행태 분석 및 고찰)

  • Kwon, Hyunjung;Jo, Hyunyoung;Kim, Youngil;Park, Kyungduck;Chung, Hyun;Park, Joonsoo
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.1
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    • pp.20-25
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    • 2015
  • Objective:To review the patterns of the dermatologic consultations of psychiatric adolescent inpatient and to explore the relationship between the dermatologic disorders and psychiatric disorders. Methods:We retrospectively studied the data from 22 cases referred by psychiatric adolescent for a dermatologic consultation over 10 years in Daegu Catholic University Medical Center and compared with the data from 108 cases referred by the other department adolescent patients. Results:The mean age of patients was 15.9. The male to female ratio was 1:1.44. The most common psychiatric and dermatologic disorder was major depressive disorder and acne, respectively. The most frequent reason for consultation was to ask for dermatologic disease or condition(54.5%) followed by to perform cosmetic procedure of patients need(40.9%) and to perform dermatologic test(4.6%). Conclusions:More than just a cosmetic disfigurement, dermatologic disorders are associated with a variety of psychopathologic problems that can affect the patient. Increased understanding of biopsychosocial approaches and liaison among psychiatrists and dermatologists could be beneficial.