• Title/Summary/Keyword: 정신과 의사

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CASE STUDY : FLUOXETINE INDUCED MANIA IN A SCHIZOPHRENIC PATIENCT AND REVIEW OF LITERATURES (정신분열증 여아환자에서 Fluoxetine 투여후 발생한 조증 증례보고 및 문헌고찰)

  • Kim, Bung-Nyun;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.116-122
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    • 1995
  • 목적 : 다음과 같은 fluoxetine으로 유발된 조증 증례를 보고한다. 이와 함께 fluoxetine사용이후 보고된 조증 증례보고를 모아서 정리하고 함께 문헌고찰을 하였다. 증례요약 : 가족력상 기분장애의 병력이 없었으며, 다른 주요 정신과적 질환의 병력은 없었다. 환아는 개인력상 5세경에 주의력 결핍, 과잉행동의 양상을 보였던 병력이 있었고, 13세때에 피해 망상, 환청이 지속되어 haloperidol로 치료받기 시작하였다. 이후 피해 망상의 내용을 언급하거나 환청에 영향받는 행동은 없어졌고 간혹 우울감을 호소하였다. 이후 정신분열증의 진단 하에 haloperidol만으로 3년간 유지하였다. 1994년 환아는 18세때 고3이 되면서 대입에 대한 걱정과 신체적인 허약감을 자주 호소하며, 우울증상이 두드려져 fluoxetine 20mg를 3일간 투여하던 중 갑자기 조증의 임상적 양상을 보이기 시작하여 본원의 입원치료를 받게 되었는데, 입원당시 보인 임상양상은 앙양된 기분, 이자극성(irritability), 사고의 비약, 연상의 이완과 지리멸렬, 과대망상, 피해망상, 관계망상, 환청 등이었고 사람, 장소, 시간에 대한 지남력까지 일시적으로 상실되는 심헌 정신병적 조증상태였다. 토의 : fluoxetine 사용이후 현재까지 세계적으로 문헌상 보고된 14개의 증례보고를 모아서 정리하였다. fluoxetine-induced mania의 병태생리학적인 기전은 명확하지 않지만 가능한 기전에 대해 토론하였다. 이 약물의 중대한 부작용중의 하나인 조증을 예방하기 위해, 이 약물을 다루는 의사는 가능한 조증 발병의 위험인자들에 대하여 인식하고, 약물의 용량조절시에도 주의를 하여야 한다. 가능한 발병 위험인자들에 관해서도 검토하였다.

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Past, Present, and Future of Psychosomatic Medicine in the Field of Korean Medical Education (한국 의학 교육에서 정신신체의학의 과거와 현재 그리고 미래)

  • Kim, Eui-Joong
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.1
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    • pp.14-17
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    • 2012
  • There were several documents that might reflect the great concern on the education of psychosomatic medicine in medical school from the 1960s. But the hour of class and proportion of psychosomatic medicine have been quite small among the total lecture time of psychiatry. Notwithstanding the importance of biopsychosocial perspective in practice and research there have been no agreement on the goal and content of teaching psychosomatic medicine in the medical school curriculum. Consultation-liaison psychiatric activity in the hospital were currently under-developed and educational content and process were not systematic. We should have established the goal of psychosomatic education in the medical school that includes making doctor who could not only cure disease but also care the ill patients. And we should develop the curriculum that covers essential area of psychosomatic medicine and checking system to monitor the process of education. With the continuance of psychosomatic perspectives from medical school education to clinical subspecialty we can make progress in this field.

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The Comparative Analysis of Overseas and Domestic cases of School-based Mental Health Project: Focusing on Singapore, the U.S., and Australia (학교중심 정신건강사업의 해외(싱가포르, 미국, 호주)와 한국의 비교분석)

  • Lee, Ju-Yong;Lee, Eun-Jin;Baik, Hyung-Ui
    • Journal of Digital Convergence
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    • v.20 no.5
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    • pp.789-802
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    • 2022
  • The purpose of this study is to present implications for effective operation of domestic school-based mental health services by comparing those in Singapore the United States, Australia. Based on reviewing the public data and previous article, researchers conducted a comparative study on the background, history, goal, and managing process of overseas and domestic organizations. The result of comparison in overseas cases suggests that the foundation of school-based mental health project was laid with the national health plan and detailed frame work for implementation. It was also discussed that domestic school-based mental health project is still in introduction stage, while foreign services were delivered efficiently through the leading agency and the cooperation between government ministries and institutions were active. It suggests that cooperation between government ministries, preparation of an effective operating system, and various approaches for students, guardians and teachers are need for domestic school-based mental health project.

A STUDY OF RELIABILITY & VALIDITY FOR THE KOREAN VERSION OF ASPERGER SYNDROME DIAGNOSTIC SCALE (한국판 아스퍼거 증후군 진단척도(The Korean version of Asperger Syndrome Diagnostic Scale : K-ASDS) 의 신뢰도 및 타당도 연구)

  • Kim, Joo-Hyun;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.98-105
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    • 2005
  • Objectives : The purpose of this study was to examine the reliability and validity of the Korean version of Asperger Syndrome Diagnostic Scale as a tool to diagnose Asperger disorder. Methods : Subjects consisted of 15 Asperger disorder, 20 PDD & PDD NOS, 20 Communication disorder children who visited the department of child psychiatric outpatient clinic. The age range of the children was between 5 years 1 month and 15 years 6 month. The K-ASDS, the Korean version of Asperger disorder inventory (K-ADI), and K-CARS were administered to mothers of all children by clinical psychologists. Results The internal consistency of the ASDS was high (Chronbach's $\alpha=0.88$) and the range internal consistencies of each subscales of K-ASDS were from .83 to 66. Correlation coefficients between K-ASDS and KADI was significant. Discriminant analysis showed that the Korean version of ASDS significantly discriminate Asperger disorder from PDD and Communication disorder, and the percentage of correct classification were $71\%$. Conclusion : The results of this study proved that the Korean version of ASDS was a reliable and valid measure for Asperger disorder.

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중기 청소년의 자기 통제력에 부모-자녀 간 개방적 의사소통이 영향을 미치는가?

  • 김진화;변상해
    • 한국벤처창업학회:학술대회논문집
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    • 2023.04a
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    • pp.67-71
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    • 2023
  • 인간은 출생부터 필연적으로 부모와 관계 속에서 다양한 경험을 통해 성장하고 발전하게 된다. 자녀가 세상에 태어나면서 부모와 언어적, 비언어적 의사소통을 통해 다양한 관계를 경험하면서 성장하고 발전하면서, 본인의 가치관 정립과 대인관계 형성을 위한 기초가 된다. 부모-자녀 간 원활하지 못한 의사소통이 자녀에게 정신건강 문제와 이탈, 비행과 범죄로 연결된다는 것을 많은 연구 사례가 볼 수가 있다. 이러한 선행연구를 살펴보면서 부모와 자녀 간의 원활한 개방적 의사소통이 자녀의 성장과 대인관계 형성을 하는 데 중요한 역할을 하지만, 원활하지 못한 의사소통이 이루어지면은 발전과 성장에 많은 문제를 가지고 청소년기를 보내고, 성인이 되어서도 건강하지 못 할 수가 있다. 본 연구의 목적은 중기 청소년의 성장 과정에서 자기 통제력 향상에 부모와 자녀의 개방적 의사소통이 원활할 때 중기 청소년의 발달과 성장에 영향을 줄 수 있는 자기 통제력에 대해 부모-자녀 간 개방적 의사소통의 매개 역할을 하는지를 검증하는 데 있다. 부모-자녀 간 메시지 전달이 감정교류 및 정보전달 등을 모두 포함하는 상호작용을 통해 성장과 발전을 할 수 있다는 것을 알 수 있다. 중기 청소년의 부모-자녀 간 원활한 의사소통에 영향을 미칠 수 있는 자기 통제력을 종속변수로 설정하여 본 연구를 검증하기 위해 진행하였다.

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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.

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 Evolutionary Medicine of Birth Decision: Psycho-Socio-Ecological Explanations (출산 의사 결정의 진화의학: 정신-사회-생태적 설명)

  • Jihyun, Ryou;Jain, Gu;Hanson, Park
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.99-111
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    • 2022
  • Akey factor in evolution is reproduction, which is also a major concern in medicine. Evolutionists have proposed many theories and hypotheses to explain the low fertility rates of modern industrial societies, which are contrary to maximization of biological fitness. Given that childbirth is the most significant factor affecting reproductive fitness, it is likely that a variety of psychological modules related to childbirth behavior and intention evolved over time. Several evolutionary psychological modules have been proposed in relation to reproduction, including sexual desire, status-seeking, a need for nurturing, and the desire for children. Previously adaptive psychological modules may now be expressed maladaptively due to the discrepancy between the Environment of Evolutionary Adaptedness (EEA) and the environment of modern industrial society. Several evolutionary ecological factors influence childbirth intention in modern society, including individual personality factors, childhood life history experiences, and socioecological factors throughout reproductive life. By focusing on mental, social, and ecological factors, this review examines several hypothetical models relating to evolutionary psychological factors and childbirth decisions in modern industrial society, as well as a possible explanation for the low birth rate.

악안면 동통환자의 치료

  • Jeong, Seong-Chang;Kim, Yeong-Gu
    • The Journal of the Korean dental association
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    • v.30 no.12 s.283
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    • pp.876-878
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    • 1992
  • 사회가 복잡다단 하여짐에 따라 스트레스의 증가는 각종 정신신체질환의 발현빈도를 증가시켜 악구강 영역에서도 악관절 동통을 포함한 광범위한 악안면 동통을 유발하고 있다. 악안면 동통 환자의 치료시에는 수술과 같은 비가역적(관혈적) 치료방법을 선택하기에 앞서 환자에 손상이 적고 경제적 부담도 적은 가역적(보존적)치료 방법을 우선 선택하여야겠다. 이에 본 악안면 동통 진료실에 방법 및 그 증례에 대해 소개하고자 한다.

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악안면 동통환자의 치료

  • Jeong, Seong-Chang;Kim, Yeong-Gu
    • The Journal of the Korean dental association
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    • v.30 no.9 s.280
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    • pp.636-637
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    • 1992
  • 사회가 복잡다단 하여짐에 따라 스트레스의 증가는 각종 정신신체질환의 발현빈도를 증가시켜 악구강 영역에서도 악관절 동통을 포함한 광범위한 악안면 동통을 유발하고 있다. 악안면 동통 환자의 치료시에는 수술과 같은 비가역적(관혈적) 치료방법을 선택하기에 앞서 환자에 손상이 적고 경제적 부담도 적은 가역적(보존적)치료 방법을 우선 선택하여야겠다. 이에 본 악안면 동통 진료실에 방법 및 그 증례에 대해 소개하고자 한다.

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