• Title/Summary/Keyword: 정신과 외래환자

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Neuropsychological Tests in Psychiatric Outpatients (정신과 외래 환자에서의 신경 심리 검사)

  • Lee, Sung-Hoon;Park, Hee-Jung;Park, Hye-Jung;Lee, Hee-Sang;Kim, Chan-Hyung
    • Sleep Medicine and Psychophysiology
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    • v.4 no.1
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    • pp.120-128
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    • 1997
  • Clinical neuropsychological tests were developed originally for the diagnosis of neurological and neuro-surgical diseases. Recently, these tests are being introduced to psychiatric patients. Authors had the experience to use these tests in pychiatric outpatient clinic. Results were as follows. There was a significantly increase in language and attentional function in residual schizophrenia compared to normal control. In chronic neurosis, as visuospatial function was reduced, language and attentional functions were enhanced. With these results, authors suggest that application of neuropsychological tests in psychiatric patients may be very helpful in classifying the subgroups of disease, in selecting the modality of treatment, and in expecting prognosis.

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Clinical Characteristics and Use of Psychotropic Agents among HIV-Infected/AIDS Patients Referred for Psychiatric Consultation (일 병원 정신건강의학과로 자문의뢰 된 HIV 감염/후천성면역결핍증 환자의 임상적 특성과 향정신약물 사용)

  • Shin, Sang-Ho;Kim, Hyun-Chung;Yoo, So-Young;Shin, Hyoung Shik;Won, Sung-Doo;Lee, So Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.31-39
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    • 2014
  • Objectives : This study aimed to investigate the psychiatric status of HIV-infected/AIDS inpatients in a general hospital over the past 2.5 years. Methods : A retrospective chart review was conducted of psychiatric consultations performed between January 1, 2011, and July 30, 2013. The records of 97 HIV-infected/AIDS patients were analyzed. These included a total of 282 psychiatric consultations. Results : Of the 97 patients, 91(93.8%) were male, the mean age was 48 years, and mean number of consultations was 2.8. Depressed mood was reported in 102 consultations(23.8%), insomnia in 60(14.0%), and anxiety in 31(7.2%). Psychiatric disorders diagnosed on initial consultation included depressive disorder(37 patients ; 37.0%), cognitive disorder(11 ; 11.0%), and delirium(9 ; 9.0%). Recommended psychotropic medication included Lorazepam(99 ; 17.2%), Escitalopram(90 ; 15.7%), and Quetiapine(84 ; 14.6%). Conclusions : The main complaints of HIV-infected/AIDS patients were depressed mood, insomnia, and suicidal ideation(including suicide attempts). In total, 85(93.3%) patients of those consulted were diagnosed as meeting the criteria for a psychiatric condition. However, considering that only 16.9% of patients consulted received follow-up treatment, longitudinal research is needed to examine the influence of psychiatric disorders on the transmission of HIV-infection/AIDS, as well as on prognosis and treatment adherence.

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Predictors of Continuity of Care after Inpatient Discharge of Patients with Bipolar Disorder : A Retrospective Chart Review Study in a University Hospital (양극성 장애 환자에서 퇴원 이후 외래 치료 유지에 영향을 미치는 예측인자 : 일 대학병원 후향적 의무기록 조사연구)

  • Wang, Hee Ryung;Jung, Young-Eun;Song, Hoo Rim;Jun, Tae-Youn;Kim, Kwang-Su;Bahk, Won-Myong
    • Mood & Emotion
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    • v.9 no.2
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    • pp.126-132
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    • 2011
  • Background and Objectives : This study aims to identify sociodemographic and disease-related variables which predicts continuity of outpatient treatment after discharge among bipolar patients. Materials and Method : The medical records of patients who discharged with the diagnosis of bipolar disorder from Department of Psychiatry, St. Mary's hospital from 2005 to 2009 were reviewed. Data on sociodemographic and disease-related variables were analyzed. Results : It showed older age, higher rate of male and higher rate of being married in 1-year follow-up group than in non-follow-up group. And it showed longer duration of index hospitalization, higher rate of previous psychiatric outpatient treatment within 3 months before index hospitalization, higher rate of involuntary admission in 1-year follow-up group than in non-follow-up group. The univariate logistic regression analysis revealed that older age, being male, previous psychiatric treatment and longer duration of index hospitalization were significantly related to an increased likelihood of 1-year follow-up visits. Conclusion : Age, sex, history of previous psychiatric treatment, and duration of hospitalization seems to have influence on continuity of outpatient treatment after discharge.

A study of Extraversion-introversion as a Dimension of Personality in Schizophrenics (정신분열증 환자에서 성격차원으로서의 외-내향성에 관한 연구)

  • Lee, Jung-Hoon
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.338-344
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    • 1993
  • The purpose of this study was to investigate the trait cortical arousal level, measured by extraversion-introversion, in schizophrenics. Subjects in this study were 231 (chronic schizophrenics=78, acute schizophrenics=62, and normal persons=91). All subjects were asked to respond to extraversion-introversion subtest scale in the korean EPQ(Korean Version Eysenck Personality Questionnaire). Collected data were analyzed by using the t-test and one-way analysis of variance. Results were as follows : 1) Trait cortical arousal level of chronic schizophrenics, which was measured by extraversion-introversion subtest scale in the Korean EPQ, was statistically higher than that of acute schizophrenics and normals. 2) Acute schizophrenics and normals were not significantly different in the trait cortical arousal level. However, the trait cortical arousal level of chronic schizophrenics was higher than that of acute schizophrenics. Therefore, it may state that the trait cortical arousal level of schizophrenics is getting higher when schizophrenic symptoms become more chronic.

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Predictors of Metabolic Syndrome in Chronic Schizophrenic Patients Followed for 5 Years(2011-2016) (5년 동안 추적한 만성 조현병 환자에서 대사증후군의 예측인자)

  • Joe, Jae-Gil;Yoon, Bo-Hyun;Jeon, Bong-Hee;Park, Su-Hee;Song, Je-Heon;Jeong, Ha-Ran;Hong, Kye Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.217-226
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    • 2016
  • Objectives : To investigate changes in, and predictors of, metabolic syndrome(MetS) status over a 5-year period in chronic schizophrenic patients and to identify factors associated with the prevention of or recovery from MetS. Methods : In total, 107 patients, all of whom provided written informed consent, were followed from 2011 to 2016 at Naju National Hospital for this study. MetS was defined according to the revised National Cholesterol Education Program-Adult Treatment Panel III guidelines. Results : During follow-up period, 22(20.5%) patients were newly diagnosed to MetS, 14(13.1%) were disappeared, 77(66.4%) were not changed[MetS : 34(31.8%), No MetS 37(34.6%)]. Common significant factors in the two changed groups were triglyceride and waist circumference, not dose and type of antipsychotic medication. Multiple logistic regression analysis revealed that female gender(odds ratio[OR]=2.846, 95% confidence interval[CI] : 1.020-7.942), attending two or more outpatient visits per month(OR=3.155, 95% CI : 1.188-8.379) and taking antidepressant medication(OR=3.991, 95% CI : 1.048-15.205) were significantly associated with MetS after controlling for other confounding variables. Type and dose of antipsychotic medication were not significantly associated with MetS. Conclusions : Triglyceride and waist circumference were important manageable indicator of MetS. Adoption of a healthy lifestyle is more important than adjusting the dose or type of antipsychotic medication in the treatment of chronic schizophrenia patients with MetS.

Psychological Analysis of BMS Patients through the SCL-90-R (간이정신진단검사를 이용한 구강작열감 환자의 심리학적 분석)

  • Jang, Yong-Seok;Tae, Il-Ho;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.33 no.1
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    • pp.49-57
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    • 2008
  • Personality characteristics of BMS patients were alalyzed psychologically by using the SCL-90-R. 59 BMS patient were subjected at Orofacial pain clinic, Department Of Oral Medicine, Pusan National University Hospital during the period from 2006 to 2007. The control group were subjected at dental clinic during the same period. 1. BMS patients group, Dental new patient group, Adult citizen groups were within normal range. 2. The T-scores of HOS, PHOB,PAR, PSY in BMS patient groups was significantly low. 3. The mean T-scores of male in BMS patients group shows the lowest HOS scale, the mean T-scores of female in BMS patient group shows the lowest PHOB scale. 4. The mean T-scores of female in BMS patients group show higher SOM, O-C, DEP, ANX, PSY scales. 5. As compared with the mean T-scores of acute and chronic group in BMS patients, there was no significant difference of the scales.

A STUDY ON THE DEFENSE MECHANISMS IN ADOLESCENT VICTIMS OF SCHOOL VIOLENCE (학교폭력 피해청소년의 방어기제에 관한 연구)

  • Park, Young-Sook;Shin, Jee-Yong;Jhin, Hea-Kyung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.158-168
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    • 1999
  • This study was carried out to know the main defense mechanisms used by adolescent victims of school violence. Subjects of this study are composed of 41 adolescent victims(clinical group) and 40 normal adolescents(control group). Clinical group is divided into four subgroups of inpatient, outpatient, day hospital, and school groups. Used scales are Ewha Defense Mechanisms Test(EDMT) and Staittrait anger scale. Several important results are found. Adoescent victims use neurotic defense mechanisms of neurotic and mature level less frequently than normal adolescents. In clinical group day hospital adolescents use more mature defense mechanisms than outpatient adolescents. Displacement and acting out are correlated with trait and sate anger. Somatization is correlated with trait anger, and regression is correlated with state anger significantly.

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A Comparison of Illness Behavior among Patients with Somatoform Disorders, Depressive Disorders and Psychosomatic Disorders (신체형장애, 우울장애 및 정신신체장애 환자들간의 질병행동의 비교)

  • Koh, Kyung-Bong;Ki, Sun-Wan
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.185-194
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    • 1997
  • A comparison was made regarding illness behavior among patients with somatoform disorders, depressive disorders and psychosomatic disorders. The subjects consisted of out-patients with somatoform disorders(N=52), depressive disorders(N=52) and psychosomatic disorders(N=51). illness behavior was assessed by illness Behavior Assessment Schedule and the questionnaire about help-seeking behavior. The patients with somatoform disorders and psychosomatic disorders more often affirmed the presence of somatic disease, were more likely to have phobia of disease, had more preoccupation with ideas of disease and more frequently shopped around oriental clinics than the patients with depressive disorders. The patients with somatoform disorders more often attributed its cause to physical factors, less often attributed the origin of affective disturbance to psychological causes, showed Less depression and irritability, and were less likely to accept psychiatric treatment recommended by other physicians than depressive patients. The patients with somatoform disorders were more likely to report having been told that they suffered from a mild illness than those with psychosomatic disorders. The patients with somatoform disorders with psychological problems tended to inhibit expression of their emotion. Female patients with somatoform disorders more often affirmed the presence of psychological disorder and attributed its cause to psychological factors than male ones. These results suggest that in illness behavior, patients with somatoform disorders are different from depressive patients, whereas the former patients are similar to psychosomatic patients except the discrepancy between therapists and patients regarding evaluation of their symptoms. Thus, it is emphasized that first, therapists need to approach patients with somatoform disorders somatically with understanding of their underlying need to deny psychological problems, followed by either psychological or biopsychosocial approach.

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Relationship Between Hopelessness and Suicidal Ideation Among Psychiatric Patients: The Mediating Effect of Sleep Quality and Interpretation Bias for Ambiguity (정신건강의학과 환자의 절망감과 자살사고의 관계: 수면의 질과 모호함에 대한 해석 편향의 매개효과)

  • Somi Yun;Eunkyung Kim;Daeho Kim;Yongchon Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.100-107
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    • 2023
  • Objectives : This study aimed to examine the mediating effect of sleep quality and interpretation bias for ambiguity in the relationship between hopelessness and suicidal ideation in psychiatric patients. Methods : A total of 231 psychiatric outpatients and inpatients completed the Beck Hopelessness Scale, Pittsburgh Sleep Quality Index, Ambiguous/Unambiguous Situations Diary-Extended Version, and Ultra-Short Suicidal Ideation Scale. Data analysis was conducted using regression analyses and bootstrap sampling. Results : The results of this study showed that hopelessness had a direct effect on suicidal ideation, and that sleep quality and interpretation bias for ambiguity mediated the association between hopelessness and suicidal ideation. Moreover, there was a significant double mediating effect of sleep quality and interpretation bias for ambiguity on the relationship between hopelessness and suicidal ideation. Conclusions : These results suggest that it is important to consider both sleep quality and interpretation bias for ambiguity to prevent hopelessness from leading to suicidal idea. These results suggest that considering both sleep quality and interpretation bias for ambiguity may be important in preventing hopelessness from leading to suicidal ideation.

Characteristics of Premenstrual Changes in Patients with Affective Disorder (정서장애 환자의 월경전기변화 특성)

  • Ko, Young-Hoon;Joe, Sook-Haeng;Suh, Kwang-Yun
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.103-115
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    • 1999
  • Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

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