• Title/Summary/Keyword: 정신과 입원 환자

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The Relation of Family History and ${\beta}$-Endorphin Levels in Alcohol Dependence (주정의존 환자에서 가족력 유무에 따른 ${\beta}$-endorphine의 반응)

  • Jeong, Hee-Yeon;Park, In-Joon;Kwon, Young-Joon
    • Korean Journal of Biological Psychiatry
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    • v.5 no.1
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    • pp.102-106
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    • 1998
  • Objectives : To evaluate the relation of familial history of alcoholism and plasma level of ${\beta}$-endorphin, ethanol, ${\beta}$-endorphin, cortisol and blood glucose were compared in 48 male alcoholics and 29 normal controls. Methods : Subjects are divided into two groups by family history of alcoholism. Blood samples were obtained before and after 0.75mg/kg of ethanol consumption at 7th admission day. Results : 1) The ratio of family history positive to negative of the patient group was 2 to 1. 2) The age at admission of positive family history group was younger than negative group. 3) There was no significant difference in change of plasma ethanol level among three groups. 4) There was no significant difference in change of plasma ${\beta}$-endorphin level among three groups. 5) There was no significant difference in change of plasma cortisol level among three groups. 6) There was no significant difference in change of fasting blood sugar level between two patient groups.

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Comparison of Clinical Characteristics among Anxiety Disorder, Depressive Disorder, and Co-morbid of Anxiety Disorder and Depressive Disorder with MMPI-2-RF (MMPI-2-RF로 살펴본 불안장애, 우울장애, 불안장애와 우울장애 공병 환자군의 임상적 특성)

  • Lee, JuYeon;Choi, Junho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.1-7
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    • 2020
  • Objectives : The purpose of this study was to explore comparison of clinical characteristics among Anxiety disorder, Depressive disorder, and Co-morbid of Anxiety disorder and Depressive disorder. Methods : Since January, 2017 to May, 2019, patients were recruited from the department of psychiatry of Hanyang University Guri Hospital. Participants were diagnosed Anxiety disorder, Depressive disorder, and Co-morbid of Anxiety disorder and Depressive disorder using DSM-5 criteria by board certified psychiatrists or clinical psychologists. And each of participants tested with MMPI-2 and clinical psychologists were converted MMPI-2 to MMPI-2-RF. The data were analyzed using SPSS 18.0. Results : The results indicated EID, RC2, HLP, SAV, and INTR-r were the highest in Co-morbid of Anxiety disorder and Depressive disorder group. And BXD, RC4, JCP, and AGGR-r were the highest in Depressive disorder group. Conclusions : The results indicated that Co-morbid of Anxiety disorder and Depressive disorder group were more severe internalizing dysfunction like lower positive emotion, helplessness, social avoidance and discomfort than single-diagnosed group. Single Depressive disorder group were more serious externalizing dysfunction like anger and aggression than single Anxiety disorder and Co-morbid of Anxiety disorder and Depressive disorder. The implications and limitations were discussed.

Changes in Psychotropic Prescription Patterns in Patients Admitted to an Open Psychiatric Ward : Eleven-Year Comparison in a University Hospital in Gyeonggi-Do (정신건강의학과 개방병동 입원 환자의 진단군별 약물 처방 경향 변화 : 경기도 소재 일 대학병원에서의 11년 비교 연구)

  • Byun, Seonjeong;Kim, Euitae;Yoo, Hee Jeong;Ha, Tae Hyon;Yoon, In-Young;Kim, Ki Woong
    • Korean Journal of Biological Psychiatry
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    • v.22 no.4
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    • pp.195-204
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    • 2015
  • Objectives This study investigated the patterns of psychotropic medications prescribed to patients admitted to an open psychiatric ward. Methods We reviewed 4282 medical records of patients who were discharged from an open psychiatric ward from May 2003 through April 2014. Data were collected on each patient's age, sex, length of hospital stay, number of past admissions, discharge diagnosis, and kinds and dosages of psychotropic medications at discharge. Results Among the 1384 male and 2898 female patients, 3.56 psychotropic medications were prescribed on average, with the number increasing across years, from 3.30 in 2003-2008 to 3.76 in 2009-2014. Prescription rates of antipsychotics, anxiolytics, and hypnotics significantly increased in patients with depressive disorders, bipolar disorders, anxiety disorders, delirium, dementia, and amnestic and other cognitive disorders. Only lithium prescription rates decreased significantly. Prescriptions for two or more anxiolytics and antipsychotics increased during the survey years, while antidepressant polypharmacy rates decreased. Conclusions Recently, there has been a significant increase in the number of psychotropic medications prescribed, including antipsychotics, anxiolytics, and hypnotics. Caution should be exercised when prescribing medications to avoid cost increases and the risk of side effects, with uncertain gains in the quality of care.

The Relevance of Caregiver Burden, Depressive symptoms and Mental Related Quality of Life in a Stroke Patient's Caregiver (뇌졸중 환자 보호자의 부양부담감 및 우울감과 정신건강관련 삶의 질과의 관련성)

  • Kim, Min-jeong;Kim, Young-Ran;Jung, Jae-Hun;Lee, Tae-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.208-218
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    • 2017
  • Objective: This study examined the caregiver burden, depressive symptoms, and mental-related quality of life of 226 caregivers of stroke patients, who had been hospitalized in 7 general hospitals located in Cheongju and Daejeon Metropolitan city. Methods: Data were collected from August 5, 2014 to October 5, 2014 and a structured self-administered questionnaire was used. The results were analyzed using a t-test, ANOVA for different comparisons of the mental related quality of life in the sociodemographic characteristics, care-related characteristics, health-related behavioral characteristics, caregiver burden, and depressive symptoms. Hierarchical multiple regression was conducted to determine the explanatory power of the independent variables on the dependent variables, with the variables showing significant differences in univariate analysis as independent variables. Results: According to the results of hierarchical multiple regression analysis, the relevant factors that influenced the mental-related quality of life were the relationship with a patient, burden by 'care', burden by sacrifice of 'personal life', and depressive symptoms. Conclusion: To enhance health-related quality of life, not only is a systematic complement on such factors needed, but the development and implementation of an intervention program to the caregiver burden and depressive symptoms is also urgently required.

Clinical Characteristics of Misdiagnosed Delirium (오진된 섬망 환자의 임상적 특징)

  • Oh, Eugene;Baek, Sue-Hyun;Kim, Min-Hyuk;Min, Seongho;Park, Ki-Chang;Ahn, Jung-Sook
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.87-92
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    • 2014
  • Objectives : Delirium of hospitalized patients is common and it is significantly associated with increased mortality rate. Misdiagnosis rates of delirium are reported in a range of 36.7 to 63% in clinical setting. We aimed to identify the clinical features and symptomatic characteristics associated with misdiagnosis of delirium. Methods : Subjects were 256 inpatients who were referred for psychiatric consultation and diagnosed with delirium by a psychiatrist at a university hospital between January 1 and June 30, 2012. Clinical data were obtained with retrospective chart review. Patients were divided into misdiagnosed group and correct diagnosed group, after reviewing the reason which were described in the consultation request form. Results : Sixty nine(27%) subjects of the 256 patients were referred for other reasons(mood, substance, anxiety, dementia etc.) than "delirium/confusion" by clinician(misdiagnosed group). In misdiagnosed group, use of antipsychotics was more common. There were no differences between the two groups in age, gender, and department of referring clinician. Fluctuation score of DRS-R-98 was higher in the correct diagnosed group. Conclusions : In this study, the risk of misdiagnosis was higher when the patients have taken antipsychotics or less symptom fluctuation. Careful clinical attention is needed for diagnosis for delirium in these patients.

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Psychological Characteristics of Suicide Attempters with Major Depressive Disorder using the Minnesota Multiphasic Personality Inventory-2 Restructured Form (다면적 인성검사 II 재구성판으로 살펴본 주요우울장애 자살 시도자의 심리적 특성)

  • Choi, Ji-Hyun;Park, Eun-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.1-10
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    • 2021
  • Objectives : This study was conducted to investigate differences in psychological characteristics between major depressive disorder (MDD) patients with and without suicide attempt using MMPI-2-RF. Methods : Subjects were 107 MDD patients who had visited the department of psychiatry of hallym university hospital and met the DSM-IV diagnostic criteria of MDD by the korean version of MINI-Plus 5.0.0. The patients were divided into suicidal attempters (n=43) and non-suicidal attempters (n=64) using C-SSRS. The one-way ANOVA was used to compare MMPI-2-RF scale scores between two groups. Additionally, ANCOVA was conducted considering the severity of depressive symptom and comorbidity as covariate. Results : Our results showed that Suicide/Death Ideation (SUI), Inefficacy (NFC) and Interpersonal Passivity (IPP) scales were significantly higher in the MDD patients with suicidal attempt compared to MDD patients without suicidal attempt (p<0.05). However, after controlling for the severity of depressive symptom and comorbidity, SUI scale showed a significant tendency (p<0.10). Conclusions : The result suggests that MMPI-2-RF scales could be a useful tool for identifying patients transitioning to actual suicidal attempts in the moderate or severe major depressive disorder group. Limitations of this study and directions for further research are also discussed.

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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Heart Rate Variability and Lipid Profile in Patients with Major Depressive Disorder (주요우울장애 환자에서의 심박변이도와 혈중 지질 농도와의 연관성)

  • Ahn, Eun-Jung;Choi, Jin-Sook;Jang, Yong-Lee;Lee, Hae-Woo;Sim, Hyun-Bo
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.27-34
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    • 2012
  • Objectives: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. Methods: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. Results: In serum lipid profile test, MDD group showed higher cholesterol ($197.68{\pm}42.94$ mg/dL vs. $176.85{\pm}34.68$ mg/dL, p=0.044), TG ($139.45{\pm}92.54$ mg/dL vs. $91.4{\pm}65.68$ mg/dL, p=0.018), LDL ($130.03{\pm}33.18$ vs. $106.62{\pm}27.08$, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant ($32.82{\pm}14.33$ ms vs. $40.36{\pm}21.40$ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group ($1.13{\pm}0.11$ vs. $0.91{\pm}0.18$, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). Conclusions: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.

Psychophysiologic Response in Patients with Panic Disorder (공황장애환자의 정신생리적 반응)

  • Chung, Sang-Keun;Cho, Kwang-Hyun;Jung, Ae-Ja;Park, Tae-Won;Hwang, Ik-Keun
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.52-58
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    • 2001
  • Objectives: An Increased level of psychophysiologic arousal and diminished physiologic flexibility would be observed in patients with panic disorder compared with a normal control group. We investigated the differences of psychophysiologic response between patients with panic disorder and normal control to examine this hypothesis. Methods: Ten Korean patients with panic disorder who met the diagnostic criteria of DSM-IV were compared with 10 normal healthy subjects. In psychological assessment, levels of anxiety and depression were evaluated by State-Trait Anxiety Inventory, Beck's Depression Inventory and Hamilton Rating Scale For Anxiety and Depression. Heart rate, respiration rate, electrodermal response, and electromyographic activity were measured by biofeedback system (J & J I-330 model) to determine psychophysiologic responses on autonomic nervous system. Stressful tasks included mental arithmetic, video game, hyperventilation, and talking about a stressful event. Psychophysiologic responses were measured according to the following procedures : baseline(3 min)-mental arithmetic (3 min)-rest (3 min)-video game (3 min)-rest (3 min)-hyperventilation (3 min)-rest (3 min)-talking about a stressful event (3 min). Results: The baseline level of anxiety and depression, electrodermal response (p=.017), electromyographic activity (p=.047) and heart rate (p=.049) of patients with panic disorder were significantly higher than those of the normal subject group. In electrodermal response, patient group had significantly higher startle response than the control group during hyperventilation (p=.001). Startle and recovery responses of heart rate in the patient group were significantly lower than responses in the control group during mental arithmetic (p=.007, p=.002). In electrodermal response of the patient group, startle response was significantly higher than recovery response during mental arithmetic (p=.000) and video game task (p=.021). Recovery response was significantly higher than startle response in respiratory response during hyperventilation. Conclusion: The results showed that patients with panic disorder had higher autonomic arousal than the control group, but the physiologic flexibility was variable. We suggest that it is helpful for treatment of panic disorder to decrease the level of autonomic arousal and to recover the physiologic flexibility in certain stressful event.

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A Clinical Study on Softening E.C.T. & Comparison of Propofol and Pentothal as Anaesthetic Agents on Seizure Duration (연성 전기 경련 요법의 임상적 고찰과 마취제 pentothal과 propofol에 따른 경련기간의 비교에 관한 연구)

  • Song, Hun-Il;Min, Kyung-Joon;Choi, Ihn-Geun;Yoo, Tae-Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.4 no.2
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    • pp.259-264
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    • 1997
  • The authors performed this preliminary study to investigate the effect of softening E.C.T. and propofol was compared to pentothal for induction of anaesthesia for E.C.T. on seizure duration. The results were follows ; 1) E.C.T. was performed in 60 psychiatric inpatients who were admitted during the study period. Of them 51.7% were diagnosed as schizophrenia, 21.6% as major depressive disorder, 16.7% as bipolar I disorder, manic and 10% of others. 2) Mean number of E.C.T. was 12.2 times a patient. 3) The most common target symptoms were persecutory delusion in schizophrenia, psychomotor retardation or agitation in major depressive disorder, and violent aggressive behavior in bipolar I disorder, manic. 4) Pre-ECT medication usually used were atropine $0.0093mgkg^{-1}$, pentothal $2.76mgkg^{-1}$ or propofol $1.42mgkg^{-1}$. 5) The duration of seizure, as measured clinically, was reduced with propofol(20.5 sec) in comparison with pentothal (35.7 sec)(p<0.001). This suggests the possibility that additional treatments may be needed for the same clinical effect in psychiatric illness when propofol is used as the induction agent.

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