• Title/Summary/Keyword: 정신과 입원 환자

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Clinical Characteristics in Patients for Mental Disability Assessment Following Traumatic Brain Injury -Comparison between Patients with and without Abnormal Brain Imaging- (두부외상 후 장애평가 환자들의 임상적 특징 -뇌영상검사 이상유무에 따른 비교-)

  • Ha, Kang-Su;Kim, Sang-Hoon;Kim, Hack-Ryul;Park, Sang-Hag;Pyo, Kyung-Sik;Cho, Yong-Rae
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.1
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    • pp.28-36
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    • 2001
  • Objectives : This study was undertaken to identify the clinical and psychological characteristics in patients of mental disability assessment following traumatic brain injury who had the finding with or without abnormal brain imaging study. Methods : A consecutive series of 59 patients were assessed in hospital from January 1994 to December 1998. Patients were divided into 2 groups based on normal or abnormal brain imaging and the two groups were compared in demographic characteristics, psychiatric symptoms, type of head injury, clinical psychological findings. There were 27 patients with abnormal findings and 32 with normal findings in brain imaging study. Results : Abnormal finding group in brain imaging study had significantly higher incidence of psychosis, decreased memory, decreased appetite, increased nihilistic idea, and intracranial hemorrhage. Also, abnormal finding group showed significantly lower level of performance on the block design subtest of K-WAIS and had significantly lower scores on F, hypochodriasis, depression, hysteria, psychopathic deviate, psychasthenia and schizophrenia subscale of the MMPI. Conclusion : The findings suggest that the patients undergone brain surgery due to intracranial hemorrage at that time of brain injury may have higher frequency of abnormal findings in brain imaging study, complain more cognitive and affective symptoms, and have lower the abstract concept formation and perceptual organization abilities.

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A Trend in Pharmacotherapy for Inpatients with Posttraumatic Stress Disorder at a Single University Hospital (일 대학병원에서 외상 후 스트레스장애 입원환자의 약물 치료 경향)

  • Min, Jung-Ah;Jung, Young-Eun;Seo, Ho-Jun;Bahk, Won-Myong;Jun, Tae-Youn;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.4 no.1
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    • pp.42-48
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    • 2008
  • Objective : Due to a better understanding of the pathophysiology of posttraumatic stress disorder (PTSD) and the relative limitations in the treatment of patients with PTSD, a variety of medications and treatment algorithms for PTSD have been investigated. This study was conducted to investigate the trends in the pharmacotherapy used in the treatment of inpatients with PTSD at a single university hospital in Korea. Methods : Data from 75 patients diagnosed with PTSD according to the DSM-IV criteria from January 1998 to December 2007 were collected. Demographic data and clinical data, including medications prescribed, were investigated. Results : Thirty-three of the 75 subjects included in this study were male, and 42 were female. Considering psychiatric comorbidity, depressive disorder, cognitive disorder, psychotic disorder and anxiety disorder were reported in order. Approximately 97% of the subjects were treated with antidepressants, including paroxetine in 54.7%, and 24% of the subjects were treated with two different kinds of antidepressants. In addition, atypical antipsychotics were prescribed in 33.3% of patients, mood stabilizers in 17.3%, and anxiolytics in 94.7% of the subjects. Conclusion : In our study, various kinds of antidepressants were prescribed for most patients with PTSD. Antipsychotics and mood stabilizers were added to the treatment regimens of some subjects, and anxiolytics were added to the treatment regimens of most subjects. Despite its many limitations, this study shows the prescription pattern and trends in PTSD treatment in Korea. We hope that these preliminary data would be helpful for the development and integration of a practical guideline for the treatment of PTSD in Korea.

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Effect of Multidisciplinary Emergency Consultation System for Drug Intoxicated Patients (응급실을 내원한 약물중독 환자에 대한 다학제 응급협진체계의 효과 검증)

  • Kang, Jino;Kim, Hye Ri;Min, Kyungjoon;Kim, Na Ryoung;Heo, Yoon Kyung;Kim, Sun Mi
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.130-137
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    • 2019
  • Objectives : When a patient who attempts suicide visits the emergency room, it is important that the departments of emergency medicine, internal medicine, and psychiatry communicate with each other and prioritize treatment. This study was conducted to verify the effectiveness of the multidisciplinary emergency consultation system (ECS) for drug intoxicated patients. Methods : We retrospectively analyzed the data from medical records prior to the ECS, from July 2017 to May 2018, and after the ECS, from July 2018 to May 2019, to verify the effectiveness of the system. Results : After the ECS, admission to open wards was significantly higher than to the intensive care units (χ2=8.567, p=0.014). In addition, the proportion of consultations to the department of psychiatry among patients admitted to other departments tended to increase (χ2=4.202, p=0.053), and the time required for consultation response decreased (Z=-2.031, p=0.042). As a result of the consultation, the proportion of the patients who had been transferred to the department of psychiatry was increased (χ2=4.692, p=0.043), and the time spent to transfer tended to decrease (Z=-1.941, p=0.052). Conclusions : After implementing the ECS for drug intoxicated patients, unnecessary intensive care unit admissions, consultation response time, and the time spent to transfer were reduced, and the rate of consultation referrals and transfer rates increased. This means that the multidisciplinary consultation system rapidly provided essential medical services to patients at lower medical costs.

A clinical report of Tension Headache (긴장성 두통 환자 치험 1례(例))

  • Kim, Ju-Won;Shin, Hyun-Kwon;Park, Se-Jin;Kong, Hyun-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.2
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    • pp.259-266
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    • 2005
  • Tension headache is one of the most common form of headache. It may occur at any age, but is most common in adults and adolescents. One cause of this muscle contraction is a response to stress that induces changes and imbalance on autonomic nerve system. And it is not easy to classify the type of tension headache simply in oriental medicine. In this case, we described a 25-year old woman who diagnosed as tension headache. She complained headache with nausea and vomiting, and her condition was improved through oriental medical treatment.

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The Rate of Diagnostic Agreement and Concordance Ratings on Psychiatric Recommendation in Consulted Delirious Cases (자문의뢰된 섬망환자에 대한 진단 일치율과 정신과 의견의 반영도)

  • Oh, Eung-Seok;Nam, Jung-Hyun;Kim, Seok-Hyeon;Park, Yong-Chon;Kim, Sung-Mok
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.174-181
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    • 2001
  • Objectives : The author investigated the rate of diagnostic agreement between consultants and consultees and concordance ratings on the consultees' recommendation to examine the interactive collaborativeness and find the factors that influence the reflectiveness on treatment. Methods : The subjects were 54 patients with delirium selected from 583 cases referred from other departments who were admitted to Hanyang University Kuri Hospital from July 1, 1995 to Dec. 31, 1997. The information on demographic data, diagnostic impression, symptoms, management before consultation, psychiatric recommendation, management after consultation, diagnoses at the referring departments and the psychiatric department on delirium was obtained by medical records and consultation papers retrospectively. The reflectiveness of the psychiatric recommendation was divided into complete concordance, partial concordance, and nonconcordance and among them the complete and partial concordance were considered for concordance. The reflectiveness was compared among all the departments and between medical unit and surgery unit. Results: The rate of diagnostic agreement on the cause of delirium was highest(85.7%) in organic brain syndrome and lowest in general medical condition(0%). There was no statistically significant differences between medical unit and surgery unit. Neither differences were there among all the departments. In comparing symptoms affecting the reflectiveness, it was 73.5% in impulsive and aggressive behavioral changes, whereas 40.0% in behavioral changes. Reflectiveness of psychiatric recommendation showed higher scores in the case of behavioral changes. The cases of sleep problem showed higher scores of reflectiveness. When these two symptoms of behavioral change and sleep problem were compared as one factor, the results suggested that there were significant differences. The cases with both two symptoms showed 80% in reflectiveness, and the cases with only one symptom or no symptoms showed 44.8% in reflectiveness. There were no statistical significances between concordance ratings and symptoms such as disturbance of consciousness, disorientation, and hallucination that cannot be easily evaluated at the referring departments. Conclusions : The rate of diagnostic agreement on the cause of delirium was highest in the case of organic brain syndrome in which lesions can be easily recognized. The factors that influence the reflectiveness of psychiatric recommendation were behavior changes and sleep disorders in the symptoms of evaluated cases.

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A Clinical Study of Probable Acute Axonal Guillain-Barré Syndrome Occurring at a Mental Hospital (한 정신병원에서 발생한 급성 축삭성 길랑-바레 증후군으로 추정되는 환자들에 대한 임상적 연구)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.2 no.2
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    • pp.81-88
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    • 2000
  • Background : Guillain-$Barr{\acute{e}}$ syndrome(GBS) is characterized clinically by acute flaccid paralysis, areflexia, and albumino-cytologic dissociation. Based on electrophysiology and pathology, GBS can be divided into either predominantly demyelinating or predominantly axonal patterns. Objectives : The clinical and laboratory status of probable acute axonal GBS occurring at a mental hospital was evaluated. Methods : Eight schizophrenia patients with probable acute axonal GBS were analyzed. Results : The mean age of the patients was 38 years old. Most of the patients were men. All patients showed an acute ascending paraparesis and/or quadriparesis with areflexia, and all have a history of schizophrenia for 3~20 years. The diseases occurred predominantly in the summer and electrodiagnostic studies revealed axonal patterns. The patients were treated by supportive care, except one patient with intravenous immunoglobulin. The prognosis was improved in 3 ; no change in 4 and 1 became aggravated. One patient with acute motor-sensory axonal neuropathy had a recurrence after 10 months of the first attack. Conclusions : Axonal GBS has been considered uncommon clinically or electrophysiologically, but 8 probable acute axonal GBSs occurring at a mental hospital have been diagnosed in 3.5 years.

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The Relationship between Psychiatric Consequences and Injury Severity Following Traffic Accidents (교통사고후 외상심각도와 정신과적 증상의 관계)

  • Lee, Moon-In;Park, Sang-Hag;Kim, Sang-Hoon;Kim, Jae-Min;Kim, Hack-Ryul
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.66-75
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    • 2004
  • Objectives: This study was intended to see the relationship between psychiatric consequences and injury severity following traffic accidents. Methods: We surveyed the 134 patients who were hospitalized from 1994 to 2003 at Chosun University Hospital for psychiatic disability evaluation following traffic accident. We reevaluate demographic factors from admission note. Psychiatric symptoms from mental status exam in medical records. Psychological tests(MMPI, BAI, BDI, K-WAIS) were done. Then we calculate the injury severity score and McBride's rate of disability due to diagnosis from emergency care hospital records. Their relationships were evaluated by statistical methods which were t-test and Pearson correlation analysis using SPSS-10. Results: When physical injury was not severe, suicidal attempt was more frequent and depression, hysteria, psychasthenia, psychopathic deviation subscales were high in MMPI. But when physical injury was severe, they have diffficulty in concentration, impaired orientation, and changed in IQ score. There was no relationship between physical injury severity and faking bad scales(F, Ds-r). Conclusion: We must not assume when physical injury was not severe, the severe sympomts are just faking for their benefit.

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Effects of Group Art Therapy Program on Self-Esteem and Mental Health Status in Chronic Schizophrenic Inpatients (집단미술요법이 만성 정신분열병 입원환자의 자존감과 정신건강상태에 미치는 영향)

  • 정길수
    • Journal of Korean Academy of Nursing
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    • v.29 no.6
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    • pp.1314-1323
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    • 1999
  • The purpose of the study was to determine the effects of the 8-week, 15-session group art therapy program on self-esteem and mental health status in chronic schizophrenic inpatients. The sample consisted of two groups of chronic schizophrenic inpatients: 10 patients with an average of total disease duration of 8.90 years who participated in a 8-week group art therapy program, and 8 comparison subjects with an average of total disease duration of 8.25 years who did not participate in the program. A pretest-posttest quasiexperimental design was used to assess self-esteem and mental health status at the beginning and at the end of the 8-week, 15-session group art therapy program. The time points for obtaining data were matched for both groups. The effectiveness of the 8-week group art therapy program was assessed by Rosenberg's Self-esteem Scale(Rosenberg, 1965) and SCL-90- R(Derogatis et al., 1973). SPSSWIN 8.0 was utilized for data entry and analysis employing Mann-Whitney U test. The findings of the study indicated the followings : (a) No significant differences were found between two groups in self-esteem and (b) The experimental group showed significantly lower scores in obsessive-compulsive symptom dimension and interpersonal sensitivity symptom dimension on the SCL-90-R than the comparison group after participating in the group art therapy program. In conclusion, the findings showed the possibility of applying group art therapy as an effective nursing intervention for patients with lack of verbal communication skills and social interaction to improve their interpersonal relationship.

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The Effect of Horticultural Program Using Vertical Garden on Helplessness, Depression, and Self-esteem in Patients with Chronic Mental Disorder (수직 정원을 이용한 원예작업프로그램이 만성 정신장애 환자의 무력감, 우울감과 자아존중감에 미치는 영향)

  • Kim, Mi young;Lim, Dong-ho
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.2
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    • pp.291-296
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    • 2021
  • The purpose of this study is to investigate the effect of gardening programs using vertical gardens on helplessness, depression, and self-esteem in patients with chronic mental disorders. This study was applied to 21 patients with chronic mental disorder who were admitted to the rehabilitation hospital of E Hospital in Seoul from June to October 2018. The group was treated as an experimental group (N = 21) 5 times a week. For 20 weeks, each session lasted 30 minutes. Patients in the experimental group programmed 4 sessions of general occupational therapy, which combined treatments to improve cognition and training, and 1 session of a horticultural program using a vertical garden. Helplessness, depression, and self-esteem were evaluated for pre and post evaluation of the horticultural program. After completing the program, the average score of helplessness in the experimental group decreased by 0.91 points from 47.38 to 46.47, and there was a statistically significant change (p=0.043). The mean score of depression in the experimental group was 9.23 before and after 9.08, which was statistically significant (p = 0.035). The average score of self-esteem in the experimental group increased by 3.14 points from 27.99 to 31.13 at a statistically significant level (p = 0.001). This result suggests that a gardening program using vertical gardens has an effect on helplessness, depression, and self-esteem in patients with chronic mental disorders. And this means that long-term plans and effective programs for recovery from chronic mental disorders to the community are needed. With a horticultural work program using a vertical garden, the helplessness of the mentally impaired in a closed treatment space is restored, and such treatment space needs to be increased.