• Title/Summary/Keyword: 정신과 자문

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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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The Investigation Regarding the Psychiatric Consultation of the Inpatient from General Hospital (일 종합병원 입원 환자의 정신과 자문 의뢰의 최근 3년간의 특성에 대한 연구)

  • Lee, Soo-Jin;Lee, Joong-Kwaun;Wang, Kwuan-Shu;Kim, Jung-Gee;Cho, Dong-Hwan;Kim, Hyun-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.49-59
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    • 2005
  • Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.

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Consultation - Liaison Psychiatry and Psychodynamics (자문조정 정신의학과 정신 역동)

  • Kim, Hyun-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.1
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    • pp.3-7
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    • 2002
  • The author reviewed the historical background of development of consultation-liaison psychiatry along with the psychosomatic medicine. Historically consultation-liaison psychiatry has developed over the past 70 years as an outgrowth of general hospital psychiatric units, and the psychodynamic approach including psychoanalysis has influenced to the development of the consultation-liaison psychiatry. Through the review, the author suggested psychodynamic understandings as a basic tool for the practicing of medical psychotherapy.

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PSYCHIATRIC CONSULTATION IN A CHILDREN'S HOSPITAL (소아병원에서의 정신과 자문)

  • Lee, Young-Sik;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.108-116
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    • 1990
  • Child Psychiatric consultations on 92 patients hospitalized at the Seoul National Childrens Hospistal were analyzed retrospectively. The main referral sources were Pedictrics(77.2%), Neurosurgery(8.91%) and Orthopedics(3.96%) Consultation rate was 0.81% for the Hospital, 1.41% for Department of Pediatrics, 3.54% for Neurosurgery and 0.3% for the other department were made for the differential diagnosis raher than for the treatment or intervention. The diagnosis of referred patients were somatoform disorder(25%), organic mental disorder(18.5%), developmental disorder(14.1), conduct disorder(6.5%), anxiety disorder(6.5%).

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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.

A CLINICAL STUDY OF CHILD AND ADOLESCENT PSYCHIATRIC CONSULTATION IN A GENERAL HOSPITAL (종합병원 소아정신과에 자문의뢰된 환아에 대한 임상적 고찰)

  • Kim Yeoung-Rang;Hong Sungdo D.;Lee Sang-Sin;Lim Seong Hu;Park Jeoung Hwan
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.72-78
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    • 2005
  • Objectives : This study is to investigate the clinical characteristics of psychiatric consultation for children and adolescents in a general hospital. Methods : Hospital records of 302 children and adolescents who were referred for psychiatric consultation in a general hospital over 4 years were reviewed and analyzed. Results : The mean referral rate for psychiatric consultation for school age children and adolescents was $2.15\%$. While more girls were referred in middle and high school age group, more boys were referred in pre-school age group. Fifty percent of the consultation was requested from department of internal medicine and pediatrics. Main reason for requesting psychiatric consultation was fur the assessment of the patients from psychiatric point of view $(31.1\%)$, followed by the management of depression $(11.6\%)$ and anxiety $(11.3\%)$. Most frequently rendered psychiatric services for the treatment was psychosocial education and supportive therapy $(21.2\%)$. Conclusion : There are differences in clinical nature of psychiatric consultation and referral patterns between adult patients and child and adolescent patients. Future research is needed to strengthen the services for child and adolescent psychiatric consultation.

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The Current Status and Changing Pattern for 5 Years of Psychiatric Consultation in a General Hospital (일 종합병원에서의 자문 현황과 5년 추이에 대한 고찰)

  • Seol, Jang-Woo;Lee, Sang-Chul;Kim, Hyun-Chul;Hong, Sang-Eui;Lee, Tae-Byoung;Lee, Sang-Kyu;Kim, Do-Hoon;Son, Bong-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.2
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    • pp.75-84
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    • 2005
  • Objectives : This study was conducted to look over the current status of psychiatric consultation in a general hospital. Methods : We analyzed 664 medical records : 317 in 2002 and 347 in 1997, and compared the records of 1997 and 2002. Results 1) The average age of the patients increased from 45.9 years(1997) to 53.2 years of age (2002). Dividing the referred patients into 3 age-brackets as below 40, between 40 and 60, and above 60, the number of patients in the age group above 60 was significantly increased, more prominently in women. 2) Overall consultation rate was 2.29% in 2002 and 2.2% in 1997 .44.2% and 57.1% of the whole referrals were from the department of internal medicine in each year, and the department of rehabilitation medicine was leading in consultation rate in both years. 3) 'Mood disorders' and 'Substance related disorders' were the most frequent diagnoses in 2002 and 1997 respectively. 4) Use of psychotropic drugs was the most frequent recommendations of psychiatric consultation, in both years, and the most frequently prescribed drugs were anti-anxiety drugs in both years. The use of SSRI and atypical anti-psychotics were increased, while the use of typical anti-psychotics was decreased significantly in 2002. Conclusion : In 2002, compared with 1997, the average age of the patients was increased, and the consultation of the patients with the diagnosis of 'mood disorders' and 'cognitive disorders' was done more frequently than in 1997. The recommendation to use psychotropic drugs was well accepted, but the concern to diagnostic procedure was relatively low.

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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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A Study on the Characteristics and Consultation Type of Inpatients Referred for Delirium and Depressive Disorder (섬망 및 우울장애로 자문 의뢰된 입원환자의 임상적 특징 및 의뢰 형태에 관한 연구)

  • Seong min Lee;Seung-Ho Ryu;Jee Hyun Ha;Hong Jun Jeon;Doo-Heum Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.10-18
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    • 2023
  • Objectives : The purpose of this study is to investigate the characteristics of patients referred for delirium and depressive disorder and to find direction of improvement of consultation-liason psychiatry in general hospital. Methods : We performed a retrospective computed chart review of the 4,966 inpatients hospitalized at Konkuk University Hospital who were referred to the Department of Psychiatry from August 1, 2005 to December 31, 2011. Results : Depressive disorder shows the order of frequency of consultation type Parallel-Complementary-Mending. Delirium shows the order of frequency of consultation type Mending-Parallel-Complementary. When comparing 'follow up consultation' and 'without follow up consultation' group within the depressive disorder, the proportion of men in the 'follow up consultation' group was higher. In the analysis of the consultation type, the 'follow up consultation' group showed the order of consultation type Parallel-Mending- Complementary, and type Parallel-Complementary-Mending in the 'without follow up consultation' group. When comparing 'follow up consultation' and 'without follow up consultation' group within the delirium, the proportion of the surgical field in the 'follow up consultation' group was higher. In the analysis of the consultation type, both group showed the order of consultation type Mending-Parallel- Complementary. Conclusions : Doctors in each department and psychiatrists should pay attention to delirium symptoms that may occur in surgical inpatients and preventive measures should be taken. Screening tests should be conducted in medical patients to properly evaluate coexisting psychiatric diseases. Risk factors of Delirium and Depressive disorder should be identified from the time of hospitalization, and actively discussing treatment plans and early interventions could improve the quality of medical services.

Alcohol Use Disorder in Consultation-Liaison Psychiatry (자문 조정의학에서의 알코올 사용 장애)

  • Seo, Jeong-Seok
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.1
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    • pp.15-19
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    • 2011
  • Alcohol is so-called "a magic bullet" affecting on the various organs and central and peripheral nervous systems and causes mental illness as well as physiological and psychological dependence. Also, alcohol problem is related with serious social problems including family violence, suicide, loss of job and crimes. Because alcohol use disorder is a common cause of consultation and liaison in general hospital, we could consider alcohol use disorder of one of psychosomatic disorder. Thus, I reviewed the prevalence, rate of consultation, and general consultant and treatment issues in treating patients with substance use disorder in a psychosomatic medicine.

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